Parapharyngeal abscess: diagnosis and treatment |
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Authors: | C Page A Biet R Zaatar V Strunski |
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Institution: | (1) ENT and Head and Neck Surgery Department, University Hospital of Amiens, Amiens, France;(2) Anatomy Department, School of Medicine, “Jules Verne” University, Amiens, France;(3) Centre Hospitalier Nord, Place Victor Pauchet, 80054 Amiens cedex, France |
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Abstract: | To study the circumstances of diagnosis, predisposing factors, bacteriology and therapeutic management of parapharyngeal abscesses.
This retrospective study over a period of 7 years concerned 16 patients hospitalized in an ENT and Head and Neck surgery department
for parapharyngeal abscess. All patients were treated by intravenous antibiotics and steroids for 5–7 days. The length of
hospital stay was 6–15 days. Parapharyngeal abscesses associated with peritonsillar and retropharyngeal abscess were all initially
aspirated transorally for evacuation and bacteriologic examination. Five patients underwent surgical drainage (two via cervical
incision, three by immediate tonsillectomy techniques and one by intra-oral drainage). Two patients presented jugular vein
thrombosis. No life-threatening complication was observed. Patients were considered to be cured when cervical CT scan performed
on D21-45 was normal. Parapharyngeal abscess is the second most common deep neck abscess after peritonsillar abscess. The
diagnosis is both clinical and radiologic. CT scan is the best imaging examination for diagnosis and follow-up of parapharyngeal
abscess. Non-complicated parapharyngeal abscesses require first-line medical management (intravenous antibiotics (amoxicillin
and clavulanic acid) combined with steroids) and follow-up CT scan. |
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Keywords: | Parapharyngeal abscess Tonsillitis Tonsillectomy |
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