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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2018 March;177(3):107-12

DOI: 10.23736/S0393-3660.17.03440-4


lingua: Inglese

Lateral neck spaces abscess: a severe complication of peritonsillar ones

Filippo RICCIARDIELLO 1, Paolo FRASCA 1, Flavia OLIVA 1, Teresa ABATE 2, Romolo VILLANI 3, Giulio SEQUINO 1, Maria PANETTI 1, Pierpaolo FERRISE 1

1 ENT Unit, AORN “Cardarelli”, Naples, Italy; 2 ENT Unit, AOU “Federico II”, Naples, Italy; 3 Department of Anesthesia, AORN “Cardarelli”, Naples, Italy


Peritonsillar abscess (PTA) represents the most common cause of parapharyngeal spaces suppuration; its incidence is 10/100.000 inhabitants for year. Abscessual process unsolved, generally because of immunodeficiency or diabetes, can get through the superior pharyngeal constrictor muscle and spread in lateral neck spaces. The authors report a case of 67 years old man affected by PTA spread to parapharyngeal space because of a delayed diagnosis and inadequate initial therapy. This delay was due to the diffusion of fluid collection toward retro-styloid space that resulted in modest oropharyngeal symptomatology. He also performed a neck ultrasonography that was not sufficient to describe the extension of the fluid collection, while the CT scan performed in Emergency Room, identified the real entity of the laterocervical abscess. Patient initially performed a wide spectrum antibiotic therapy and a transoral drainage of the abscess, but it also needed surgery for drainage of laterocervical space. Aim of this study was underlining the importance of a proper diagnostic iter if it is suspected an extension to laterocervical space of a peritonsillar abscess and moreover the authors highlighted on primary role played by surgery in the treatment of such a dramatic complication of an acute pharyngeal infection, because in this cases it remains the procedure of choice.

KEY WORDS: Peritonsillar abscess - Surgical procedures, operative - Drainage

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