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Transoral drainage of a Retropharyngeal Abscess

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

Transoral Incision and Drainage of Retropharyngeal/Parapharyngeal space Abscess
Abscess located medial to great vessels in the parapharyngeal space or accessible transorally for the retropharyngeal space
Inability to access oral cavity adequately for drainage purposes
Setup is same as for tonsillectomy; in this video, Crowe-Davis mouth retractor was utilized, oral RAE tube for intubation
CT scan or MRI with contrast to confirm abscess formation
Be aware that the great vessels will lie just laterally in the parapharyngeal space along with lower cranial nerves
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
Bleeding, need for re-drainage of the abscess
Bleeding, need for re-drainage of the abscess
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