J Korean Soc Radiol.  2012 Apr;66(4):309-316. 10.3348/jksr.2012.66.4.309.

A Comparative Study of Deep Neck Abscess with Regards to Anatomical Location and Age Groups Using CT and Clinical Data

• Park CH
• Han JK
• Kim YT
• Shin HC
• Kim HH
• Jou SS

• KMID: 2208842
• DOI: http://doi.org/10.3348/jksr.2012.66.4.309

Abstract

PURPOSE
To evaluate differences anatomical location and age groups on CT and clinical data in deep neck abscess.
MATERIALS AND METHODS
This study included 200 patients who underwent CT and were diagnosed with a deep neck abscess, from December 2005 to July 2010. Patients were divided into four groups by age (children, adolescent, adult, elderly). Next, the anatomic location, location multiplicity and clinical data regarding the deep neck abscesses were analyzed restrospectively. The deep neck abscesses observed were defined as superficial or deep and partitioned into sub-groups, with further analysis of their clinical data.
RESULTS
The incidence of the parapharyngeal abscess was more frequent in children and elderly groups (p < 0.05). The masticator abscess was only observed among patients in the elderly group (p < 0.05). Multiple locations were observed with increased frequecy in children and elderly groups (p < 0.05). Swelling in the neck was more frequently observed in children and elderly groups (p < 0.05), cervical lymphadenitis was frequently seen in children and adolescent groups (p < 0.05), and the incidence of symptoms including sore throat were significantly increased in adolescent and adult groups (p < 0.05). Location multiplicity was significantly higher in parapharyngeal, retropharyngeal, submandibular, danger, visceral and masticator spaces than other spaces (p < 0.05). With regards to anatomic location, neck swelling was more frequent in superficial group and sorethroat was more frequent in deep group (p < 0.05).
CONCLUSION
Deep neck abscess would show significant differences with regards to the abscess location, location multiplicity, and clinical symptoms according to age. The clinical symptoms observed are dependent on the anatomic location as defined by a superficial or deep abscess.

MeSH Terms

Abscess
Adolescent
Adult
Aged
Child
Humans
Incidence
Lymphadenitis
Neck
Pharyngitis

Figure

• 

  Fig. 1 A 4-year-old boy with deep neck abscess. Contrast enhanced CT shows abscess in (A) parapharyngeal space (arrow), (B) retropharyngeal space (black arrowhead) and danger space (open arrow) through direct extension.

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  Fig. 2 Deep neck abscess in a 67-year-old woman who had diabetes mellitus. A. Contrast enhanced CT shows abscess in right parapharyngeal space (arrow). B. Contrast enhanced CT shows abscess in right submandibular space (arrowhead). C. Contrast enhanced CT shows right masticator abscess (open arrow) by direct extension from right parapharyngeal and submandibular abscesses.

• 

  Fig. 3 Deep neck abscess with necrotizing fasciitis in a 67-year-old woman. She had history of diabetes mellitus. A. Contrast enhanced CT shows abscess in both submandibular space combined with necrotizing fasciitis (arrows). B. Contrast enhanced CT shows abscess with necrotizing fasciitis in left masticator space (open arrow) by direct extension from submandibular abscess.

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