Parapharyngeal abscess

Overview parapharyngeal abscess (parapharyngeal abscess) is the parapharyngeal space has purulent inflammation The abscess formation. Parapharyngeal space for the buccal pharyngeal fascia prevertebral fascia and the potential gaps, starting on the base of the skull, issued hyoid cornu. on the inside is pharyngeal constrictor muscle and fascia cheek pharynx, parotid for lateral, the former foreign to the mandible or extension and lateral pterygoid muscle, after prevertebral fascia. Parapharyngeal space from the styloid process and the muscle attachment styloid process is divided into before and after the gap. Parapharyngeal space were filled with loose connective tissue and a few lymph nodes, and the former neighboring palatine tonsil, with the retropharyngeal space separated. Pathology Disease (1) from the surrounding tissue suppurative inflammation expansion, as occurred around the tonsil infections and around tonsil abscess, retropharyngeal abscess, parotid abscess, abscess molars, Beizuo ears Germany abscesses. (2) caused by trauma, such as a 61 stab wounds and surgical trauma, bacterial infection caused by direct access from pyogenic abscess. (3) the lymphatic system infections, such as acute pharyngitis, acute tonsillitis, rheumatoid crown weeks. (4) Hematogenous from infection, but clinical rare. Clinical manifestations systemic severe symptoms, fever, chills, body temperature was flip-heat and sweating, headache, loss of appetite, or even collapse. Parapharyngeal lateral neck and severe pain, dysphagia, pronunciation unclear, sometimes trismus. Inspection : ipsilateral neck and lower jaw and swelling after mandibular angle, inconsistent and hard tenderness, severe reached parotid gland, issued sternocleidomastoid and supraclavicular fossa there swelling. As infection in the deep neck, the skin surface without congestive also failed to get a sense of volatility. Pharyngeal wall uplift and congestive slightly, tonsil itself with or without disease can be pushed inside. Diagnosis based on symptoms and signs is not difficult to diagnose. When necessary pus aspiration can be diagnosed. But with the need around the tonsil abscess, retropharyngeal abscess and mandibular lymphadenitis and mumps as well. Common complications were infection carotid sheath so that the internal carotid artery wall erosion to the pharynx to break the fatal bleeding, or break the formation of pseudoaneurysms and pretended to swallow incision and drainage must be made should be taken with caution. If internal jugular vein infection, thrombosis can occur phlebitis or sepsis. Infection can occur down the proliferation of mediastinitis. Actively anti-infection treatment, the blood appropriate rehydration therapy and strengthening support. Abscess formation timely incision and drainage must be made. (1) the throat drainage : swelling of the throat most obvious incision and drainage must be made. (2) by the neck drainage : midpoint of the mandibular angle in front of sternocleidomastoid muscle for a longitudinal incision, also from the lower edge of the mandible in other parallel beneath about 1 cm for a transverse incision. After the skin incision with vascular clamp pure separation until soft tissue abscess, and drainage must be made after the drainage of the home. Partially wound suture.