J Korean Assoc Oral Maxillofac Surg.  2010 Aug;36(4):314-319. 10.5125/jkaoms.2010.36.4.314.

Retropharyngeal space abscess due to spread of odontogenic infection: two cases report

• Jung TY
• Chae BM
• Jeong YS
• Park SJ

• KMID: 1457785
• DOI: http://doi.org/10.5125/jkaoms.2010.36.4.314

Abstract

Odontogenic infections are a normally locally confined, self-limiting process that is easily treated by antibiotic therapy and local surgical treatment. However, it may spread into the surrounding tissues through a perforation of the bone, and into contiguous fascial spaces or planes like the primary or secondary fascial spaces. If the infection extends widely, it may spread into the lateral pharyngeal and retropharyngeal space. The retropharyngeal space is located posterior to the pharynx. If an odontogenic infection spreads into this space, severe life-threatening complications will occur, such as airway obstruction, mediastinitis, pericarditis, pleurisy, pulmonary abscess, aspiration pneumonia and hematogenous dissemination to the distant organs. The mortality rate of mediastinitis ranges from 35% to 50%. Therefore, a rapid evaluation and treatment are essential for treating retropharyngeal space abscesses and preventing severe complications. Recently, we encountered two cases of a retropharyngeal space abscess due to the spread of an odontogenic infection. In all patients, early diagnosis was performed by computed tomography scanning and a physical examination. All patients were treated successfully by extensive surgical and antibiotic therapy.

Keyword

Retropharyngeal space abscess; Odontogenic infection

MeSH Terms

Abscess
Airway Obstruction
Early Diagnosis
Humans
Lung Abscess
Mediastinitis
Pericarditis
Pharynx
Physical Examination
Pleurisy
Pneumonia, Aspiration

Figure

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  Fig. 1. Axial view of CT shows pus formations of the left submandibular, lateral pharyngeal and retropharyngeal space and deviation of upper airway tract to right. (CT: computed tomography)

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  Fig. 2. Axial view of CT shows more increased pus formations of the left submandibular, lateral pharyngeal, retropharyngeal, right submandibular, submental and prevertebral space and more increased deviation of upper airway tract to right than previous axial view of CT.

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  Fig. 3. Axial view of CT shows decreased pus formations of the left submandibular, lateral pharyngeal, retropharyngeal, right submandibular, submental and prevertebral space and decreased deviation of upper airway tract to right than previous axial view of CT.

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  Fig. 4. Axial view of CT shows pus formations of the left and right submandibular, submental space. There is no deviation of upper airway tract.

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  Fig. 5. Axial view of CT shows more increased pus formations of the right lateral pharyngeal and left lateral pharyngeal and left retropharyngeal space. There is no deviation of upper airway tract.

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  Fig. 6. Axial view of CT shows decreased pus formations of the right lateral pharyngeal and left lateral pharyngeal and left retropharyngeal space.

Reference

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