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Retropharyngeal abscess--the foreign body connection
Insights
Retropharyngeal abscesses are more common in adults than children, often caused by regional trauma from ingested foreign bodies. Lateral neck radiographs are crucial for diagnosis, with specific widening measurements indicating the condition.
Area of Science:
- Otolaryngology
- Medical Imaging
- Surgical Pathology
Background:
- Retropharyngeal abscesses are typically associated with pediatric populations and oropharyngeal infections.
- This study challenges the conventional view by observing a higher incidence in adults within a specific demographic.
Purpose of the Study:
- To investigate the epidemiological characteristics and etiological factors of retropharyngeal abscesses in adult patients.
- To evaluate the diagnostic utility of lateral neck radiography in identifying retropharyngeal abscesses.
Main Methods:
- Retrospective review of 23 consecutive patients with retropharyngeal abscesses treated between January 1983 and June 1989.
- Analysis of patient demographics, symptoms, diagnostic methods, and complications.
- Measurement of retropharyngeal and retrotracheal widths in 210 normal lateral neck radiographs to establish population-specific normal ranges.
Main Results:
- Adults were more frequently affected than children in this series.
- Ingested foreign bodies causing regional trauma were identified as the leading cause in 56.5% of cases.
- Lateral neck radiography proved highly valuable, with all patients exhibiting significant retropharyngeal (>5 mm) and/or retrotracheal (>15 mm) widening.
Conclusions:
- Retropharyngeal abscesses in this population are more prevalent in adults, with foreign body ingestion being a primary etiological factor.
- Lateral neck radiography is an essential diagnostic tool for evaluating the retropharyngeal space and confirming abscess presence.
Abstract:
Retropharyngeal abscesses have been described to be more common among children especially under the age of three or four years and oropharyngeal infection have been implicated as a common etiological factor. However, this series reveals that retropharyngeal abscesses are more commonly seen in adults in our local population. Regional trauma resulting from an ingested foreign body is the leading cause of retropharyngeal abscess in this series. Twenty-three patients seen consecutively between January 1983 and June 1989 at the Department of Otolaryngology, Singapore General Hospital were reviewed retrospectively. Factors such as age, sex, racial distribution, presenting symptoms and signs, methods used to arrive at diagnosis, therapy and complications were studied and analysed. A lateral radiograph of the neck was the single most valuable investigation in the evaluation of the retropharyngeal space. Retropharyngeal and retrotracheal width were measured in 210 normal lateral neck radiographs to establish a normal range in our population. Retropharyngeal widening greater than 5 mm and retrotracheal widening greater than 15 mm was considered significant and was noted in all 23 patients. Regional trauma resulting from an ingested foreign body was the cause of the retropharyngeal abscess in thirteen (56.5%) patients.