[Differential diagnosis and management of retropharyngeal space-occupying lesions]

Diseases of the retropharyngeal space place high request on the diagnostic and therapeutic knowledge of the otorhinolaryngologist.

Under consideration of six own cases and of all other published case reports, this inhomogeneous symptom is analysed systematically.

Commonly, these alterations of the retropharyngeal space are observed incidentally during routine throat examination or in patients suffering from dyspnoea, dysphagia, dysphonia, sleep apnoea syndrome or neck pain. Six own cases show the very inhomogeneous aetiology (retropharyngeal abscess, lipoma, malignant schwannoma, sarcoidosis, aberrant internal carotid artery, Forestier disease). Therefore, before surgery, a sufficient radiologic diagnosis (lateral neck radiography and CT or MRI respectively) is necessary to avoid grave complications (injury to the cervical spine, the brain, the spinal cord or the internal carotid artery). A tissue sample can be obtained by the transoral approach while the lateral cervical approach seems to be the better way to treat a retropharyngeal abscess.

Because of the very different aetiology of retropharyngeal space diseases the therapy finally depends on the definite diagnosis.