Parapharyngeal Abscess

Question 1

What muscles is this space medial and lateral to?

Answer 1

Medial to the pterygoid muscle

Lateral to the superior pharyngeal constrictor

Question 2

It is divided into…

Answer 2

Anterior and posterior compartments by the styloid process

Question 3

What does the posterior compartment contain?

Answer 3

The carotid sheath - carotid artery, IJV, Vagus nerve, deep cervical nodes

Question 4

Where does the infection usually originate from?

Answer 4

Tonsils
Pharynx
Teeth
Lymph nodes

Question 5

It can present in a similar manner to what?

Answer 5

Peritonsillar abscess

Question 6

What symptoms are associated?

Answer 6

Sore throat 
Odonophagia
Trismus 
Reduced neck movement 
Fever

Question 7

What signs are associated?

Answer 7

Swelling of neck

Can get medial bulging of tonsils and lateral pharyngeal wall

Question 8

What complications can occur?

Answer 8

Compromise of airway
Posterior space abscess can erode into carotid artery - haemorrhage
Septic thrombophlebitis of IJV (Lemierre syndrome)

Spread to retropharyngeal space
Spread to mediastinum

Question 9

How is it managed?

Answer 9

Secure airway if concerns
IV antibiotics
Surgical drainage

Question 10

How is it diagnosed?

Answer 10

CT neck