Abstract
Parapharyngeal (PPA) and retropharyngeal abscess (RPA) are relatively rare, but serious deep throat infections, associated with potentially significant morbidity and mortality. In spite of the primary tendency to evacuate the area of the abscess the possibility of conservative approach in the treatment is still under professional consideration.
In the three-year period of 2005 through 2007 the authors treated 13 child patients with this kind of diagnosis. The suspicion based on clinical picture was confirmed by imaging of the inflammatory focus by magnetic or CT with the use of a contrast medium.
Four children with a lesion of a smaller size and abscess positioned high under the cranium base were successfully treated conservatively only. In 9 patients a surgical intervention was indicated.
Six of them were treated by means of transoral incision and evacuation of the abscess. In three patients the transoral puncture proved to be negative (without aspirated purulence).
Among these three patients two were cured up conservatively without the need of further intervention, in the third patient with multiple abscesses in parapharyngeal, retropharyngeal and paravertebral region, revision from external approach was performed. The intraoral incision of the same focus had to be performed twice in two patients.
All these patients finally healed up completely. In six patients who were cured up without surgical evacuation of the abscess the foci proved to be of smaller size and less apparent clinical symptomatology.
No postoperative complications have been encountered, and all patients of the group survive.