Pharyngeal Mucosal Space Abscess: A Special Entity That Merits Special Management-Our Experience in 106 Cases

Background: Deep neck infections represent a common but heterogeneous medical condition, as clinical manifestations and outcomes vary, depending, among others, on the infection site. The pharyngeal mucosal space (PMS) represents the most superficial neck space, confined between the pharyngeal mucosa and the pharyngeal constrictor muscles. The collection of pus in the PMS (pharyngeal mucosal abscess (PMA)) is considered rare and is rarely reported in the literature. This study focuses on infections of the pharyngeal mucosal space, aiming to provide an elaborate description of the clinical behavior of this category and reporting its differences from other categories of deep neck infections (DNIs). Methods: A retrospective study of 743 cases of deep neck infections was conducted in a single tertiary center. Cases of abscesses, confined in the pharyngomucosal space (PMAs), were studied, reporting demographics, clinical features, imaging, bacteriology, and treatment data, and comparisons with other DNIs were made. Results: A total of 106 cases of pharyngomucosal space abscesses (PMAs) were reported, representing 14.3% of deep neck infections (DNIs). Dysphagia, odynophagia, and fever were the most common symptoms. Hospitalization with non-surgical drainage was the treatment of choice, resulting in complete recovery with no complications. Conclusions: In conclusion, the frequency of PMAs in our series suggests that they may not be as rare as they are considered to be. Symptoms and clinical findings can be similar to those of other DNIs, especially parapharyngeal abscesses, but, overall, PMAs seem to have a milder clinical behavior, highlighting the need for diagnosis and reporting as a separate, recognizable category.