Retropharyngeal and parapharyngeal infections in children: the Toronto experience

Daya, Hamid; Lo, S.H.; Papsin, Blake C.; Zachariasova, A.; Murray, Heather; Pirie, Jonathan; Laughlin, Suzanne; Blasér, Susan

doi:10.1016/j.ijporl.2004.08.010

Cited by 131 publications

(113 citation statements)

References 12 publications

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“…Also, clinical characteristics of our DNI patient population are consistent with those of other studies. The percentage of RP versus PP abscesses in this study (71% vs.26%) and in the 306 total cases of DNI presenting at our institution over this time period (59% versus 41%) are similar to previously reported proportions of 50-85% RP and 11-44% PP [4,6,9]. In addition, only associations can be reported, as each decision to proceed to surgery was made using both clinical and radiologic data.…”

Section: Discussionsupporting

confidence: 86%

“…Widespread use of antibiotics has allowed for a shift in practice from operative management for all suspected abscesses to use of initial medical (26) 26 (96) 20 (74) 16 (59) 7 (26) 33 (94) 28 (80) 23 (66) 9 (26) 0.42 0.20 0.18 0.23 (40) 13 (21) 2 (3) 9 (33) 11 (41) 6 (22) 1 (4) 13 (37) 14 (40) 7 (20) 1 (3) 1.00 (19) 16 (26) 17 (27) 18 (29) 17 (63) 7 (20) 6 (22) 10 (37) 9 (33) 22 (62) 5 (19) 10 (29) 7 (20) 9 (26) [2,7,9,[11][12][13], especially in older children [14]. A larger study of empiric antibiotic trials showed 75% resolution without surgery, with no subjects having adverse outcomes (death, major complications, or recurrence), leading the authors to recommend a trial of initial IV antibiotic therapy for all stable patients with DNIs [15].…”

Section: Discussionmentioning

confidence: 99%

“…Needing surgery was defined as those patients who underwent surgery and revealed purulent drainage and those patients who did not initially undergo surgery but then presented as medical treatment failures [6][7][8][9]. Not needing surgery was defined as those patients who underwent surgery but did not reveal purulent drainage and those patients who underwent medical treatment with resolution of their DNI.…”

Section: Methodsmentioning

confidence: 99%

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The Utility of a Second CT Scan in the Management of Parapharyngeal and Retropharyngeal Abscesses in Pediatric Patients

2015

Int J Otorhinolaryngol

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Objective: To evaluate the utility of follow-up CT imaging for predicting the need for surgical intervention in pediatric patients with deep neck infections (DNI) admitted for a trial of observation with medical management.Methods: Pediatric patients admitted with DNI from January 2000 to February 2009 who underwent a CT scan, initial medical management, and repeat CT scan were identified and separated into two cohorts: patients who underwent surgical intervention and patients treated with medical management. Necessity of surgical intervention following the repeat CT scan was determined and the predictive values of CT imaging characteristics and clinical characteristics for identifying necessary surgical interventions were calculated.Results: 62 patients met inclusion criteria. Of the 32 patients who underwent surgical intervention following their second CT scan, 75% revealed an abscess. Of the 30 patients who continued with medical management following the second CT scan, 10% failed medical management. The combination of increased size, increased peripheral enhancement, and walling off of collections on subsequent CT imaging yielded 83% specificity for identifying patients who needed surgical intervention. Interpretation of the collection as a phlegmon or abscess on the repeat CT scan by the radiologist yielded 96% sensitivity for identifying patients who needed surgical intervention. Conclusion:Follow-up CT imaging can assist with determining the need for surgical intervention in children with deep neck infections initially managed medically.Citation: Elmaraghy CA, Mahida JB, Pluto CP, Minneci PC, Deans KJ, et al. The Utility of a Second CT Scan in the Management of Parapharyngeal and

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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The Utility of a Second CT Scan in the Management of Parapharyngeal and Retropharyngeal Abscesses in Pediatric Patients

2015

Int J Otorhinolaryngol

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“…[1,2] Nadir görülen bir durum olmasına rağmen, havayolu obstrüksiyonu, servikal nekrotizan fasiit, mediastinit, juguler ven trombozu, karotis arter anevrizması gibi ölüm-cül komplikasyonlara yol açabilmesi açısından önemlidir. [3][4][5][6] Çoğunlukla üst solunum yolu enfeksiyonuna ikincil gelişen lenf nodlarının süpürasyonuna bağlı olarak oluşur. [7] Sıklıkla çocukluk çağında görülür ve ortalama görülme yaşı 3 ay-3 yaş olarak değişmektedir.…”

Section: Discussionunclassified

“…[7] Sıklıkla çocukluk çağında görülür ve ortalama görülme yaşı 3 ay-3 yaş olarak değişmektedir. [5] Çocukluk çağında yetişkinlere oranla daha sık görülmesi-nin en önemli nedeni retrofarengeal lenf nodlarının beş yaşından sonra atrofiye uğramasıdır. [6] Erişkin yaşta retrofarengeal apse ile karşılaşıl-dığında travma ya da geçirilmiş cerrahi öyküsü sorgulanmalıdır.…”

Section: Discussionunclassified

Giant retropharyngeal abscess in pediatric patient: case report

Demir

Doğan²,

Ecevit³

2016

Kulak Burun Bogaz Ihtis Derg

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ÖZÜç aydır devam eden boğaz ağrısı ve bir aydır devam eden ağrılı boyun şişliği nedeniyle başka bir merkeze başvuran iki yaşındaki kız hastaya antibiyoterapi başlanmış, ancak iyileşme sağlanamamıştı. Daha sonra, hasta kliniğimize yönlendirildi ve manyetik rezonans görüntülemede boyunun her iki lateral alanına uzanan bir apse saptandı. Hastaya acil cerrahi drenaj uygulandı. Yaraya rifampisin ile pansuman yapıldı ve hastaya parenteral antibiyoterapi başlandı. Hastada dramatik bir iyileşme gözlendi ve herhangi bir komplikasyon olmadı.Anahtar Sözcükler: Enfeksiyon; boyun; pediatrik; retrofarengeal apse. ABSTRACTA two-year-old girl patient, who presented to another center with three months of sore throat and one month of neck swelling with pain, was initiated antibiotherapy but no healing was achieved. Afterwards, the patient was directed to our clinic and an abscess was detected in magnetic resonance imaging extending in both lateral spaces of the neck. The patient was performed surgical drainage urgently. The wound was dressed with rifampicin and the patient was started parenteral antibiotherapy. A dramatic recovery was observed and no complication occurred in the patient.

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Pediatric Mediastinitis as a Complication of Methicillin-Resistant Staphylococcus aureus Retropharyngeal Abscess

Wright¹,

Stocks²,

Armstrong³

et al. 2008

Arch Otolaryngol Head Neck Surg

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Retropharyngeal and parapharyngeal infections in children: the Toronto experience

Cited by 131 publications

References 12 publications

The Utility of a Second CT Scan in the Management of Parapharyngeal and Retropharyngeal Abscesses in Pediatric Patients

The Utility of a Second CT Scan in the Management of Parapharyngeal and Retropharyngeal Abscesses in Pediatric Patients

Giant retropharyngeal abscess in pediatric patient: case report

Pediatric Mediastinitis as a Complication of Methicillin-Resistant Staphylococcus aureus Retropharyngeal Abscess

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