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Published on: November 6, 2019
Intraoral drainage under surgical microscopy with tonsillectomy for parapharyngeal abscesses
Y Okumura1, H Hidaka1, N Noguchi1
1Department of Otolaryngology - Head and Neck Surgery,Tohoku University Graduate School of Medicine,Sendai,Japan.
Insights
This study presents a minimally invasive intraoral surgical technique for treating pediatric parapharyngeal abscesses, avoiding external incisions. The approach, utilizing surgical microscopy, proved effective and safe for accessing deep head and neck infections in children.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Head and Neck Surgery
Background:
- The parapharyngeal space is challenging to access, especially in pediatric patients with abscesses.
- Previous literature lacks investigation into intraoral techniques for pediatric parapharyngeal abscesses.
Observation:
- This study details an intraoral drainage technique combined with tonsillectomy for pediatric parapharyngeal abscesses.
- The procedure was performed under surgical microscopy for enhanced visualization and access.
- Two pediatric cases with abscesses extending to the skull base were successfully treated.
Findings:
- The intraoral approach combined with tonsillectomy provided effective drainage for pediatric parapharyngeal abscesses.
- Surgical microscopy facilitated access to the deep parapharyngeal space, including extension to the skull base.
- Patients experienced a favorable postoperative course without complications.
Implications:
- This minimally invasive technique obviates the need for external skin incisions in treating pediatric parapharyngeal abscesses.
- The use of surgical microscopy enhances safety and efficacy in managing complex pediatric head and neck infections.
- The described procedure and its clear surgical recording facilitate knowledge sharing among medical professionals.
Background:
An intraoral approach combined with tonsillectomy has been used to access the parapharyngeal space. However, the utility of this technique for parapharyngeal abscesses in paediatric patients has not been investigated. This paper describes an intraoral drainage technique combined with tonsillectomy for treating children with a parapharyngeal abscess that obviates the need for skin incision.
Methods:
Clinical case records are presented, along with a description of the surgical procedure accompanied by a video clip.
Results:
Both cases encountered involved paediatric parapharyngeal space abscesses that extended to the skull base. The patients underwent an intraoral approach combined with tonsillectomy performed under surgical microscopy; this resulted in a good post-operative course without complications.
Conclusion:
To our knowledge, no previous reports have addressed the use of surgical microscopy to help access the parapharyngeal space. The procedure described herein, performed under surgical microscopy, was specifically helpful in enabling access to these challenging spaces; it also meant that surgical procedures could be recorded clearly and findings shared with other medical staff.
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