Trudności diagnostyczne w rozpoznawaniu ropni głębokich szyi: przestrzeni przygardłowej i zagardłowej u dzieci

Monika Jabłońska-Jesionowska, *Lidia Zawadzka-Głos

Summary
Introduction. Deep neck abscesses in retropharyngeal and parapharyngeal spaces are rare and always cause diagnostic difficulties. There are complications of upper respiratory tract infections. Due to their position in the deep parts of the neck, well demarcated from the muscle tissue and the superficial fascia and lack of the characteristic symptoms diagnosis is often delayed. The anatomical connections of the spaces can cause life-threatening complications. Treatment is based on intravenous antibiotics and surgical external drainage or via mouth.
Aim. Analyze the group of children with the deep neck abscesses in spite of symptoms, diagnostic methods and results of treatment.
Material and methods. In the Department of Pediatric Otolaryngology on Warsaw Medical University in 2008-2013 due to abscesses or inflammatory infiltrates in the deep neck spaces were treated 18 children aged from 7 months to 14 years.
Results. All children in the period before the diagnosis of the inflammatory process in the deep neck spaces have a upper respiratory tract infections. The reason for admission to the ENT department were: enlarged lymph nodes, dysphagia, trismus, shortness of breath, hoarseness, limiting the mobility of the neck. In all children ultrasound and CT scan of the neck with contrast were done. The ultrasound examination in all cases showed inflammation of the lymph nodes of the neck. The exact location and size of the changes showed the CT scan.
Conclusions. All children were treated with cefuroxime and clindamycin. Retropharyngeal space abscesses were also treated surgically by incision through the mouth. All children were cured.

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