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Minimally invasive transoral image-guided drainage of a retropharyngeal abscess with mediastinal extension
Christina Stevens1, Patricia Ladd2, Saied Ghadersohi3
1University of Colorado School of Medicine, Aurora, CO, USA.
Insights
Retropharyngeal abscess (RPA) in children can spread to the mediastinum. A minimally invasive transnasal drainage technique guided by imaging offers a novel surgical solution for this rare complication.
Area of Science:
- Pediatric Surgery
- Infectious Diseases
- Medical Imaging
Background:
- Retropharyngeal abscess (RPA) is a severe deep neck infection in children.
- Mediastinal extension of RPA is a rare but life-threatening complication.
- Prompt surgical intervention is crucial for RPA with mediastinal involvement.
Observation:
- A 3-year-old boy presented with RPA and mediastinal extension.
- A multidisciplinary team involving otolaryngology and interventional radiology managed the case.
- A unique approach utilized a transoral route for drain placement.
Findings:
- A transnasal drain was successfully placed into the mediastinal fluid collection using image guidance.
- This minimally invasive technique facilitated drainage of the abscess.
- The patient's condition was managed effectively through this novel approach.
Implications:
- This case highlights a unique, minimally invasive surgical technique for managing RPA with mediastinal extension in children.
- The multidisciplinary approach and image-guided transnasal drainage offer a promising alternative to traditional surgical methods.
- Further research into this technique could refine treatment strategies for deep neck space infections.
Abstract:
Retropharyngeal abscess (RPA) in children is a serious deep neck space infection that rarely is complicated by extension into the mediastinum. RPA with mediastinal abscess requires prompt surgical management, generally via external or transoral approach. We present the case of a 3-year-old boy with RPA with mediastinal extension who was managed with a unique multidisciplinary surgical approach with otolaryngology and interventional radiology. A transoral approach was utilized to pass a transnasal drain with image guidance into the mediastinal fluid collection. This report reviews the presentation and surgical management of RPA with mediastinal extension and describes a unique minimally invasive approach to drainage.
