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Retropharyngeal abscess management in children: current practices.
1Division of Otolaryngology-Head and Neck Surgery, Santa Clara Valley Medical Center, San Jose, CA 95128, USA.
Summary
Pediatric retropharyngeal abscesses (RAs) are rare. Most pediatric otolaryngologists use CT scans for diagnosis and often try antibiotics before surgery, with many believing RAs can resolve with antibiotics alone.
Area of Science:
- Pediatric Otolaryngology
- Infectious Diseases
Background:
- Retropharyngeal abscesses (RAs) in children are uncommon in the current antibiotic era.
- Limited contemporary literature exists on the management of pediatric RAs.
- This study addresses the need for updated information on RA care.
Purpose of the Study:
- To determine the current standard of care for pediatric retropharyngeal abscesses.
- To survey pediatric otolaryngologists regarding their diagnostic and management practices for RAs.
- To compare current practices with existing literature.
Main Methods:
- A survey was distributed to the membership of the American Society of Pediatric Otolaryngology.
- The survey achieved a response rate of 77.5%.
- Data collected included preferred diagnostic methods, antibiotic trial indications, and surgical techniques.
Main Results:
- Computed tomography (CT) is the preferred diagnostic method for 72% of practitioners.
- Nearly two-thirds of respondents occasionally recommend a trial of intravenous antibiotics before operative drainage.
- 51% believe 20-40% of RAs may resolve with antibiotics alone.
- Intraoral incision and drainage is the preferred surgical technique for 83% of respondents.
- Tracheotomy and short-term intubation are rarely necessary.
Conclusions:
- This survey defines contemporary management practices for pediatric retropharyngeal abscesses among pediatric otolaryngologists.
- Current practices indicate a trend towards conservative management, including antibiotic trials.
- Surgical intervention, primarily intraoral drainage, is reserved for specific cases.