Parapharyngeal abscess

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A parapharyngeal abscess is a deep neck space abscess of the parapharyngeal space (or pharyngomaxillary space), which is lateral to the superior pharyngeal constrictor muscle and medial to the masseter muscle. [1] This space is divided by the styloid process into anterior and posterior compartments. The posterior compartment contains the carotid artery, internal jugular vein, and many nerves. [2]

Contents

Signs and symptoms

Symptoms include fever, sore throat, painful swallowing, and swelling in the neck. [2] An anterior space abscess can cause lockjaw (spasm of jaw muscle), and hard mass formation along the angle of the mandible, with medial bulging of the tonsil and lateral pharyngeal wall. A posterior space abscess causes swelling in the posterior pharyngeal wall, and lockjaw is minimal. Other structures within the carotid sheath may be involved, causing rigors, high fever, bacteremia, neurologic deficit, or a massive haemorrhage caused by carotid artery rupture. [2]

Cause

Infection can occur from:

Epidemiology

Parapharyngeal abscess is more common in male than the female gender. [4] [5] Any age group can develop a parapharyngeal abscess but it is most commonly seen in children and adolescents. [6] Adults who are immunocompromised are also at high risk. [7]

Related Research Articles

Trismus Medical condition

Trismus, commonly called lockjaw as associated with tetanus, is a condition of limited jaw mobility. It may be caused by spasm of the muscles of mastication or a variety of other causes. Temporary trismus occurs much more frequently than permanent trismus. It is known to interfere with eating, speaking, and maintaining proper oral hygiene. This interference, specifically with an inability to swallow properly, results in an increased risk of aspiration. In some instances, trismus presents with altered facial appearance. The condition may be distressing and painful. Examination and treatments requiring access to the oral cavity can be limited, or in some cases impossible, due to the nature of the condition itself.

Articles related to anatomy include:

Parotid gland Major salivary gland in many animals

The parotid gland is a major salivary gland in many animals. In humans, the two parotid glands are present on either side of the mouth and in front of both ears. They are the largest of the salivary glands. Each parotid is wrapped around the mandibular ramus, and secretes serous saliva through the parotid duct into the mouth, to facilitate mastication and swallowing and to begin the digestion of starches. There are also two other types of salivary glands; they are submandibular and sublingual glands. Sometimes accessory parotid glands are found close to the main parotid glands.

External carotid artery Major artery of the head and neck

The external carotid artery is a major artery of the head and neck. It arises from the common carotid artery when it splits into the external and internal carotid artery. External carotid artery supplies blood to the face and neck.

Carotid sheath

The carotid sheath is an anatomical term for the fibrous connective tissue that surrounds the vascular compartment of the neck. It is part of the deep cervical fascia of the neck, below the superficial cervical fascia meaning the subcutaneous adipose tissue immediately beneath the skin.

Retropharyngeal space

The retropharyngeal space is a potential space of the head and neck, bounded by the buccopharyngeal fascia anteriorly and the alar fascia posteriorly.

Carotid triangle

The carotid triangle is a portion of the anterior triangle of the neck.

Head and neck anatomy

This article describes the anatomy of the head and neck of the human body, including the brain, bones, muscles, blood vessels, nerves, glands, nose, mouth, teeth, tongue, and throat.

Buccal space

The buccal space is a fascial space of the head and neck. It is a potential space in the cheek, and is paired on each side. The buccal space is superficial to the buccinator muscle and deep to the platysma muscle and the skin. The buccal space is part of the subcutaneous space, which is continuous from head to toe.

Cervical lymph nodes

Cervical lymph nodes are lymph nodes found in the neck. Of the 800 lymph nodes in the human body, 300 are in the neck. Cervical lymph nodes are subject to a number of different pathological conditions including tumours, infection and inflammation.

Prevertebral fascia

The prevertebral fascia is a fascia in the neck.

Buccopharyngeal fascia

The buccopharyngeal fascia is a fascia in the head and neck.

Pharynx Part of the throat that is behind the mouth and nasal cavity

The pharynx is the part of the throat behind the mouth and nasal cavity, and above the oesophagus and trachea. It is found in vertebrates and invertebrates, though its structure varies across species. The pharynx carries food and air to the esophagus and larynx respectively. The flap of cartilage called the epiglottis stops food from entering the larynx.

Parapharyngeal space

The parapharyngeal space, is a potential space in the head and the neck. It has clinical importance in otolaryngology due to parapharyngeal space tumours and parapharyngeal abscess developing in this area. It is also a key anatomic landmark for localizing disease processes in the surrounding spaces of the neck; the direction of its displacement indirectly reflects the site of origin for masses or infection in adjacent areas, and consequently their appropriate differential diagnosis.

Sublingual space

The sublingual space is a fascial space of the head and neck. It is a potential space located below the mouth and above the mylohyoid muscle, and is part of the suprahyoid group of fascial spaces.

Guttural pouches are large, auditory-tube diverticula that contain between 300 and 600 ml of air. They are present in odd-toed mammals, some bats, hyraxes, and the American forest mouse. They are paired bilaterally just below the ears, behind the skull and connect to the nasopharynx.

Submandibular space

The submandibular space is a fascial space of the head and neck. It is a potential space, and is paired on either side, located on the superficial surface of the mylohyoid muscle between the anterior and posterior bellies of the digastric muscle. The space corresponds to the anatomic region termed the submandibular triangle, part of the anterior triangle of the neck.

Submasseteric space

The submasseterric space is a fascial space of the head and neck. It is a potential space in the face over the angle of the jaw, and is paired on each side. It is located between the lateral aspect of the mandible and the medial aspect of the masseter muscle and its investing fascia. The term is derived from sub- meaning "under" in Latin and masseteric which refers to the masseter muscle. The submasseteric space is one of the four compartments of the masticator space. Sometimes the submasseteric space is described as a series of spaces, created because the masseter muscle has multiple insertions that cover most of the lateral surface of the ramus of the mandible.

Pterygomandibular space

The pterygomandibular space is a fascial space of the head and neck. It is a potential space in the head and is paired on each side. It is located between the medial pterygoid muscle and the medial surface of the ramus of the mandible. The pterygomandibular space is one of the four compartments of the masticator space.

Infratemporal space

The Infratemporal space is a fascial space of the head and neck. It is a potential space in the side of the head, and is paired on either side. It is located posterior to the maxilla, between the lateral pterygoid plate of the sphenoid bone medially and by the base of skull superiorly. The term is derived from infra- meaning below and temporal which refers to the temporalis muscle.

References

  1. Cuete, David; et al. "Radiology Reference Article: Parapharyngeal abscess". Radiopaedia.org. Retrieved 28 February 2017.
  2. 1 2 3 Sasaki, Clarence T. (October 2016). "Ear, Nose, and Throat Disorders: Parapharyngeal Abscess". MSD Manual Professional Edition. Merck Sharp & Dohme Corp. Retrieved 28 February 2017.
  3. Dhingra, PL (2014). Diseases of Ear, Nose and Throat & Head and Neck Surgeries (6th ed.). Elsiver. ISBN   978-81-312-3431-0.[ page needed ]
  4. "Parapharyngeal Abscess". The Lecturio Medical Concept Library. Retrieved 2 September 2021.
  5. Grisaru-Soen G, Komisar O, Aizenstein O, Soudack M, Schwartz D, Paret G (September 2010). "Retropharyngeal and parapharyngeal abscess in children--epidemiology, clinical features and treatment". Int J Pediatr Otorhinolaryngol. 74 (9): 1016–20. doi:10.1016/j.ijporl.2010.05.030. PMID   20598378 . Retrieved 2 September 2021.
  6. Croche Santander, B.; Prieto Del Prado, A.; Madrid Castillo, M.D.; Neth, O.; Obando Santaella, I. (2011). "Abscesos retrofaríngeo y parafaríngeo: Experiencia en hospital terciario de Sevilla durante la última década" [Retropharyngeal and parapharyngeal abscess: experience in a tertiary-care center in Seville during the last decade]. Anales de Pediatría. 75 (4): 266–72. doi:10.1016/j.anpedi.2011.03.010. PMID   21531183.
  7. Alaani, A.; Griffiths, H.; Minhas, S. S.; Olliff, J.; Drake Lee, A. B. (2004). "Parapharyngeal abscess: Diagnosis, complications and management in adults". European Archives of Oto-Rhino-Laryngology. 262 (4): 345–50. doi:10.1007/s00405-004-0800-6. PMID   15235797.