Artikel
Surgical Management of the Retropharyngeal Abscess
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Autoren
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P. Schuler
- Department of Otorhinolaryngology, University Hospital Duesseldorf, Duesseldorf, Germany
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J. Greve
- Department of Otorhinolaryngology, University Hospital Duesseldorf, Duesseldorf, Germany
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M. Cohnen
- Department of Radiology, University Hospital Duesseldorf, Duesseldorf, Germany
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J. Chereath
- Department of Otorhinolaryngology, University Hospital Duesseldorf, Duesseldorf, Germany
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C. Koll
- Department of Otorhinolaryngology, University Hospital Duesseldorf, Duesseldorf, Germany
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K. Scheckenbach
- Department of Otorhinolaryngology, University Hospital Duesseldorf, Duesseldorf, Germany
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J. Schipper
- Department of Otorhinolaryngology, University Hospital Duesseldorf, Duesseldorf, Germany
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T.K. Hoffmann
- Department of Otorhinolaryngology, University Hospital Duesseldorf, Duesseldorf, Germany
| Veröffentlicht: | 8. Juli 2008 |
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Gliederung
Text
The retropharyngeal space (RPS) is located between the ventral musculus constrictor and the posterior prevertebral fascia. In the lateral extension it is bordered by the great cervical vessels and vertically it reaches from the cranial basis to C7/Th2.
Nine patients with RPA were treated in a 28 months time period in a tertiary care teaching hospital. Main outcome measure was the clinical resolution of the abscess. Besides fever and a reduced general condition, all patients presented with restricted cervical mobility. All patients obtained CT and/or MRI-scan on admission. The mean abscess volume was 7.8 cm³. Surgical intervention was performed in all cases, among those five patients underwent a transoral approach, two were treated by a transcervical and two by a combined cervical / transoral operation. We experienced one recurrence and in one case surgical tracheotomy was unavoidable during the course of disease.
Growth of streptococcal species was verified in four of the examined abscesses. Abscessing lymphadenitis, infection of a cervical cyst and previous GLOA-treatment were identified as causative factors.
Retropharyngeal abscesses are potentially life threatening, requiring appropriate otorhinolaryngologic as well as radiologic diagnostics, medical and surgical intervention by a transoral and/or transcervical approach in a multidisciplinary setting.
