[Contribution of x-ray computed tomography in the diagnosis of cervical suppuration]

The authors report their experience with computed tomography (CT) in 27 cases of cervical suppurations. The diagnosis was confirmed surgically in 24 cases and by the improvement of clinical signs and CT after antibiotics in 3. Two types of CT features were identified: collected abscesses (n = 22) visualized as encapsulated heterogeneous hypodense formations and extensive suppurative cellulitis (n = 5) formed by large diffuse hypodense collections without a clearly visible peripheral wall. The extension of the suppurative process could be evaluated precisely with CT, especially in certain anatomic areas where physical examination is difficult including mediastinal suppurations (n = 2), extension of parapharyngeal suppurations to the retrostyleal area (n = 1), and pterygo-maxillary and epidural collections (1 each) the latter in combination with a tuberculous abscess. Computed tomography is also useful in the etiological diagnosis (search for foreign body, cystic malformations, tuberculosis) and in post-treatment follow-up to visualize the absence of collections after cure in cases of favourable outcome and to determine the extent of the suppurative process in case of complications.