Parapharyngeal abscess

Parapharyngeal abscesses are deep neck abscesses involving the parapharyngeal space. It is a serious medical condition, potentially fatal, and requires prompt diagnosis treatment.

A person of any age can develop a parapharyngeal abscess, but it is most commonly seen in children and adolescents 1. Immunocompromised adults are also at an increased risk 2.

Presentation is variable, the first symptoms of a parapharyngeal abscess are likened to those of a common throat infection.

The first steps are identical to those of uncomplicated acute pharyngitis or tonsiliits (fever, sore throat, nasal voice, dysphonia, cervical lymphadenopathy). Progression of the signs and symptoms is key as it pertains to inflammation and obstruction of the upper airways and/or gastrointestinal tract and there may be dysphagia, dyspnoea, stridor, neck stiffness, drooling, trismus and/or chest pain.

Usually, parapharyngeal abscesses arise secondary to oropharyngeal infections that spread either by direct continuity or by lymphatic drainage:

When a parapharyngeal abscess is detected, treatment should commence immediately. It can usually be treated with broad-spectrum parenteral antibiotics and surgical drainage. Occasionally, small abscesses can be treated with IV antibiotics alone 1.

Parapharyngeal space infections are important causes of morbidity and mortality due to the possible complications including 2:

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Article information

rID: 23090
System: Head & Neck
Section: Pathology
Synonyms or Alternate Spellings:

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Cases and figures

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    Case 1
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    Case 2 (extension from retropharyngeal space)
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    Case 3
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