Infrahyoid spread of deep neck abscess: anatomical consideration

Area of Science:

• Anatomy
• Radiology
• Infectious Diseases

Background:

• Deep neck infections, particularly oropharyngeal abscesses, pose a significant risk of mediastinal spread.
• Understanding the anatomical pathways of abscess extension is crucial for effective management and preventing severe complications.

Purpose of the Study:

• To elucidate the infrahyoid pathway of oropharyngeal abscess extension.
• To correlate abscess spread with the anatomy of deep cervical fascial spaces using cross-sectional imaging.

Main Methods:

• Retrospective review of CT scans and MR images from ten patients with known infrahyoid extension of oropharyngeal abscesses.
• Analysis of abscess location and trajectory within the fascial planes of the neck.

Main Results:

• Abscesses frequently descended along the deep cervical fascia towards the hyoid bone.
• The anterior cervical space was identified as a significant pathway for mediastinal extension in four patients.
• The retropharyngeal space was involved in seven patients, with direct mediastinal extension in two.
• One case demonstrated mediastinal spread via the posterior cervical space.

Conclusions:

• Cross-sectional imaging is invaluable for evaluating deep neck abscesses and their spread patterns.
• The anterior cervical space plays a critical role in the infrahyoid mediastinal extension of pharyngeal abscesses.