Transoral drainage of a Retropharyngeal Abscess

Video Type: CVideo
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Author: Soham Roy
Published:
Specialties: Otolaryngology
Schools:
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Basic Info

Retropharyngeal and parapharyngeal abscess are common in the pediatric population. When medial to the great vessels, a transoral approach to incision and drainage avoids the potential morbidity of external incisions and dissection through the parapharyngeal space. 

DOI: http://dx.doi.org/10.17797/cbobe92kzw

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Procedure

Transoral Incision and Drainage of Retropharyngeal/Parapharyngeal space Abscess

Indications

Abscess located medial to great vessels in the parapharyngeal space or accessible transorally for the retropharyngeal space

Contraindications

Inability to access oral cavity adequately for drainage purposes

Instrumentation

Setup

Setup is same as for tonsillectomy; in this video, Crowe-Davis mouth retractor was utilized, oral RAE tube for intubation

Preoperative Workup

CT scan or MRI with contrast to confirm abscess formation

Anatomy and Landmarks

Be aware that the great vessels will lie just laterally in the parapharyngeal space along with lower cranial nerves

Advantages/Disadvantages

Easier access to medial abscesses; will not work well for abscesses located laterally to the great vessels. Avoids the morbidity of extensive dissection in the parapharyngeal space for medially located abscesses approached externally

Complications/Risks

Bleeding, need for re-drainage of the abscess

Disclosure of Conflicts

Bleeding, need for re-drainage of the abscess

Acknowledgements

References

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