Adequate Management of Retropharyngeal Abscess

Jeong, Ji Seong; Lee, Dong Wook; Yeon, Je Yeob

Abstract

BACKGROUND AND OBJECTIVES
The incidence of retropharyngeal abscess has been decreased with use of antibiotics, but it still causes critical complications such as airway obstruction, aspiration pneumonia, mediastinitis, or sepsis. For this reason, early diagnosis and proper management of retropharyngeal abscess should be undertaken as soon as possibile. The treatment includes maintaining airway, performing surgical drainage, and administering antibiotics; but there are no definite guidelines for treating patients with retropharyngeal abscess, nor a golden rule for the correct surgical approach. SUBJECTS AND METHOD: A retrospective analysis of patients with retropharyngeal abscess who were treated at the Chungbuk University Hospital from 1993 to 2003 was performed. We analized general symptoms, signs, causing factors, and causing bacteria. We also analized the treatment outcome and selected approaches from the surgically treated patients. RESULTS: The general symptoms of retropharyngeal abscess were sore throat, fever, dyspnea, with the most common cause being the upper airway infection. Bacteriologically, hemolytic streptococcus was the most common bacteria among aerobes and bacteroides was the most common bacteria among anaerobes. However, in most cases, both aerobe and anaerobes were cultured at the same time. Among 18 cases, 6 cases were treated conservatively with antibiotics and surgical interventions were performed in 12 cases, which included 11 cases of transoral and 1 case of transcervical approach. CONCLUSION: Retropharyngeal abscess can be treated with either conservative or surgical treatment according to initial abscess size. The abscess size which is greater than 3 cm is prefered to be treated surgically, and transoral approach is a useful way of dealing with less invasive procedure.