Retropharyngeal Abscess. Clinical Review of Twenty-five Years

Area of Science:

• Otolaryngology
• Infectious Diseases
• Surgical Pathology

Background:

• Retropharyngeal abscess (RPA) presents diagnostic challenges due to its rarity and overlapping symptoms with other conditions.
• Early diagnosis and treatment are crucial to prevent severe complications associated with RPA.

Purpose of the Study:

• To investigate the epidemiology, pathogenesis, clinical features, causative agents, treatment, morbidity, and mortality of retropharyngeal abscesses.
• To analyze data from a tertiary institution over a 25-year period.

Main Methods:

• Retrospective study of medical records from January 1990 to February 2016.
• Inclusion of 33 patients diagnosed with retropharyngeal abscess.
• Data collection included personal history, presenting illness, diagnoses, and treatments.

Main Results:

• Incidence of 0.2 cases/100,000 inhabitants/year.
• Commonly associated factors: alcoholism, smoking, diabetes, obesity.
• Most frequent etiology: foreign body impaction (fishbone).
• Key symptoms: odynophagia, neck pain, fever.
• Preventive tracheotomy in 27% of cases.
• Most common complication: descending necrotizing mediastinitis.
• Surgical drainage in 82% of cases, primarily via external approaches.
• Sequelae: unilateral vocal cord paralysis, Horner's syndrome.
• Zero mortality observed.

Conclusions:

• Retropharyngeal abscesses are medical-surgical emergencies requiring immediate attention.
• Warning symptoms include odynophagia, cervical pain, dyspnea, stridor, trismus, and neck stiffness.
• Advances in diagnostics, therapeutics, and critical care have improved prognosis and reduced mortality.