Hostname: page-component-76fb5796d-dfsvx Total loading time: 0 Render date: 2024-04-27T01:57:16.779Z Has data issue: false hasContentIssue false
  • English
  • Français

Intraoral drainage under surgical microscopy with tonsillectomy for parapharyngeal abscesses

Published online by Cambridge University Press:  22 April 2015

Y Okumura ,
H Hidaka ,
N Noguchi  and
Y Katori
Y Okumura
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
H Hidaka*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
N Noguchi
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
Y Katori
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
*
Address for correspondence: Dr Hiroshi Hidaka, Department of Otolaryngology – Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryomachi, Aoba-ku, Sendai 980-8575, Japan Fax: +81-22-717-7307 E-mail: Zay00015@nifty.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

An intraoral approach combined with tonsillectomy has been used to access the parapharyngeal space. However, the utility of this technique for parapharyngeal abscesses in paediatric patients has not been investigated. This paper describes an intraoral drainage technique combined with tonsillectomy for treating children with a parapharyngeal abscess that obviates the need for skin incision.

Methods:

Clinical case records are presented, along with a description of the surgical procedure accompanied by a video clip.

Results:

Both cases encountered involved paediatric parapharyngeal space abscesses that extended to the skull base. The patients underwent an intraoral approach combined with tonsillectomy performed under surgical microscopy; this resulted in a good post-operative course without complications.

Conclusion:

To our knowledge, no previous reports have addressed the use of surgical microscopy to help access the parapharyngeal space. The procedure described herein, performed under surgical microscopy, was specifically helpful in enabling access to these challenging spaces; it also meant that surgical procedures could be recorded clearly and findings shared with other medical staff.

Keywords

AbscessUpper Respiratory Tract InfectionsRetropharyngeal AbscessMicrosurgery
Type
Short Communications
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 6 , June 2015 , pp. 595 - 597
Copyright
Copyright © JLO (1984) Limited 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Baldassari, CM, Howell, R, Amorn, M, Budacki, R, Choi, S, Pena, M. Complications in pediatric deep neck space abscesses. Otolaryngol Head Neck Surg 2011;144:592–5CrossRefGoogle ScholarPubMed
2Amar, YG, Manoukian, JJ. Intraoral drainage: recommended as the initial approach for the treatment of parapharyngeal abscesses. Otolaryngol Head Neck Surg 2004;130:676–80CrossRefGoogle ScholarPubMed
3Coulthard, M, Isaacs, D. Retropharyngeal abscess. Arch Dis Child 1991;66:1227–30CrossRefGoogle ScholarPubMed
4Page, NC, Bauer, EM, Lieu, JE. Clinical features and treatment of retropharyngeal abscess in children. Otolaryngol Head Neck Surg 2008;138:300–6CrossRefGoogle ScholarPubMed
5Cable, BB, Brenner, P, Bauman, NM, Mair, EA. Image-guided surgical drainage of medial parapharyngeal abscesses in children: a novel adjuvant to a difficult approach. Ann Otol Rhinol Laryngol 2004;113:115–20CrossRefGoogle ScholarPubMed
6Platzer, W, Brenner, E, Thumfart, WF, Gunkel, AR. Transoral approach to the parapharyngeal space. In: Thumfart, WF, Platzer, W, Gunkel, AR, Maurer, H, Brenner, E, eds. Surgical Approaches in Otorhinolaryngology. New York: Thieme, 1999;113–16Google Scholar
7Sichel, JY, Attal, P, Hocwald, E, Eliashar, R. Redefining parapharyngeal space infections. Ann Otol Rhinol Laryngol 2006;115:117–23CrossRefGoogle ScholarPubMed
8Daya, H, Lo, S, Papsin, BC, Zachariasova, A, Murray, H, Pirie, J et al. Retropharyngeal and parapharyngeal infections in children: the Toronto experience. Int J Pediatr Otorhinolaryngol 2005;69:81–6CrossRefGoogle ScholarPubMed
9Beriault, M, Green, J, Hui, A. Innovative airway management for peritonsillar abscess. Can J Anaesth 2006;53:92–5CrossRefGoogle ScholarPubMed
10Hidaka, H, Ishida, E, Suzuki, T, Matsutani, S, Kobayashi, T, Takahashi, S. Unusual parapharyngeal extension of peritonsillar abscess to the masticator space: successfully drained by extraoral and intraoral endoscopic approaches. Ann Otol Rhinol Laryngol 2014;123:333–7CrossRefGoogle Scholar
11Lee, CH, Lee, TJ, Chen, CW. Transnasal endoscopic approach for drainage of pediatric parapharyngeal space abscess. Otolaryngol Head Neck Surg 2010;143:467–8CrossRefGoogle ScholarPubMed