Anatomic-Pathologic Studies of Retropharyngeal (Peripharyngeal) Abscess

Abstract

Weintraub1 has described three important types of connective tissue in the body. These connective tissues may occur in the form of (1) periorgan sheets, surrounding or enclosing organs or muscles, or (2) nerve-vessel sheets, originating from nerve-vessel trunks and conveying the blood and nerve supply to the structures or organs in which they terminate (the nerve-vessel sheets of the neck, therefore, bear a close resemblance to the mesenteries of the bowel), or (3) loose elastic areolar tissue, within the spaces of the neck as elsewhere in the body. Areolar tissue spaces are found between adjacent nerve\x=req-\ vessel sheets, between adjacent organs and within the periorgan tissues of many structures of the neck.The areolar spaces permit free movement between the muscles and organs and attain their greatest development in those regions in which mobility is most important in the physiologic functioning of the organs involved. Thus, in the neck the loosest space is found postviscerally, permitting free movement of the pharynx and the esophagus during movements of the head and also during the acts of deglutition, coughing, vomiting and the like.Weintraub separates the connective tissues of the neck by blunt dissection, avoiding the knife and the creation of artefacts. The demonstration of nerve-vessel sheets, periorgan sheets and areolar spaces offers a rational explanation of the complicated arrangement of the connective tissues of the neck quite at variance with the classic subdivision From the

Deep Infections of the Neck With a Special Study Of 32 Cases

“…Since the widespread use of sulphonamides and of antibiotics these have become less common and in the present series of cases caused relatively little concern. One fatal case, in which erosion of the internal carotid artery occurred with fatal haemorrhage, during the course of a parapharyngeal abscess, has previously been reported from this department (Insley, 1944).…”

“…Weintraub (1941) prefers the term peripharyngeal to retropharyngeal and describes right and left peripharyngeal spaces separated by a septum. Iglauer (1941) also discards the term retropharyngeal. Davidson (1949) states that it is incorrect to describe only one space behind the pharynx.…”