China
Africa
Explore chapters and articles related to this topic
Oropharynx
Published in Neeraj Sethi, R. James A. England, Neil de Zoysa, Head, Neck and Thyroid Surgery, 2020
The retropharyngeal space runs from the base of the skull to the level of T6, posterior to the pharynx and oesophagus. Retropharyngeal lymph nodes are found in the portion of the retropharyngeal space superior to the hyoid bone. These lymph nodes drain the pharynx, nasal cavity, paranasal sinuses and the middle ear. Thus, infections in the pharynx can potentially lead to suppurative lymphadenopathy and abscess formation in this space. These lymph nodes are more prominent in children, and largely atrophy by adulthood, explaining why retropharyngeal abscesses are more common in young children and adolescents. The contents include areolar fat, lymph nodes and small vessels.
Retropharyngeal abscess
Published in Alisa McQueen, S. Margaret Paik, Pediatric Emergency Medicine: Illustrated Clinical Cases, 2018
The prevertebral soft tissue space is widened. Thickening of the prevertebral soft tissue space greater than 7 mm at the level of the second cervical vertebrae and/or greater than 14 mm at the level of the sixth cervical vertebrae is abnormal. A lateral neck radiograph has a high false-positive rate due to positioning, swallowing, and respiratory effort. Computed tomography with intravenous contrast of the neck is done. The key image demonstrates an abscess in the retropharyngeal space. A retropharyngeal abscess is a suppurative deep neck infection occurring in the potential space between the posterior pharyngeal wall and prevertebral fascia, from the base of the skull to the posterior mediastinum.
Paediatric deep neck space infections
Published in S. Musheer Hussain, Paul White, Kim W Ah-See, Patrick Spielmann, Mary-Louise Montague, ENT Head & Neck Emergencies, 2018
The retropharyngeal space is bound anteriorly by the posterior pharyngeal wall, posteriorly by the alar fascia and superiorly by the skull base. Its inferior extent is the superior mediastinum at the level of T2, where the middle and deep cervical fascial layers fuse. It communicates laterally with the parapharyngeal space and may drain into the prevertebral space.
Incidence and risk factors of pneumonia following acute traumatic cervical spinal cord Injury
Published in The Journal of Spinal Cord Medicine, 2023
Tetsuo Hayashi, Yuichi Fujiwara, Osamu Kawano, Yuzo Yamamoto, Kensuke Kubota, Hiroaki Sakai, Muneaki Masuda, Yuichiro Morishita, Kazu Kobayakawa, Kazuya Yokota, Hironari Kaneyama, Takeshi Maeda
Severe dysphagia (DSS score ≤ 4), categorized as aspiration, was associated with 5 times the risk of pneumonia compared with mild dysphagia (DSS score ≥ 5) in this study. Although a few studies have reported the relationship between dysphagia and pneumonia in individuals with CSCI, Chaw E and Shem K7, 8 reported individuals with dysphagia had statistically higher occurrences of pneumonia when compared with those without dysphagia. Furthermore, multivariate analysis in our study suggested that aspiration was one of the significant risk factors for pneumonia. We previously demonstrated that one of the significant causes for dysphagia following acute CSCI was the morphological change accompanied with swelling of retropharyngeal space,6 which might cause pharyngeal residue. Accordingly, pharyngeal residue may cause aspiration pneumonia. As in stroke-associated pneumonia, aspiration played a vital role in the pathogenesis of CSCI-associated pneumonia.16
Otolaryngologic manifestations of Mpox: the Atlanta outbreak
Published in Acta Oto-Laryngologica, 2023
Kaitlyn A. Brooks, Nathaniel S. Neptune, Douglas E. Mattox
On HD 1, he was taken to the operating room (OR) for direct laryngoscopy and transoral incision and drainage of the retropharyngeal space. OR findings included pharyngeal and supraglottic edema but no pustular lesions. Dishwater fluid was expressed from the retropharynx. He initially improved but worsened on HD 5 and returned to the OR for a repeat incision and drainage. During his second operation, intubation was difficult due to supraglottic edema. After multiple attempts by the anesthesia team, he was ultimately intubated by the otolaryngology team via transoral flexible fiberoptic intubation. Dishwater fluid was once again expressed from the retropharynx and he remained intubated postoperatively. A large groin rash was discovered with lesions at different stages of pustules and crusts. Infectious disease concluded his rash was concerning for HSV. On HD 7, he underwent tracheostomy. Skin lesion PCR was positive for Orthopoxvirus DNA on HD 8.
Epidural pneumorrhachis in COVID-19: a rare clinical entity
Published in Journal of Community Hospital Internal Medicine Perspectives, 2021
Shiavax J. Rao, Pallavi Lakra, Abhinandan R. Chittal, Michael Aughenbaugh, Christopher J. Haas
Pneumorrhachis is an uncommon entity characterized by air entrapment in the spinal canal, with most cases occurring in the setting of penetrating or blunt force trauma, instrumentation and spinal cord injuries[1]. Pneumorrhachis in patients with COVID-19 is an extremely rare finding, minimally reported in the literature[2]. We describe a unique case of epidural pneumorrhachis associated with pneumomediastinum and pneumopericardium in the setting of worsening COVID-19 infection, with extensive air tracking into the subcutaneous tissues and retropharyngeal space. Increases in intra-alveolar pressure and alveolar rupture can lead to movement of air into the perivascular interstitium, leading to pneumomediastinum and air tracking in the retropharyngeal space. Continued air dissection from the retropharyngeal space through the neural foramina can subsequently lead to pneumorrhachis [3,4]. In many cases, pneumorrhachis is a self-limiting condition and a conservative treatment approach is appropriate in patients that are stable from a neurological and cardiopulmonary standpoint [3]. Nevertheless, given the volatile nature of this clinical entity, prompt recognition, urgent evaluation by a specialist, close monitoring and appropriate management can lead to improved patient outcomes. We describe a unique case of epidural pneumorrhachis associated with pneumomediastinum and pneumopericardium in the setting of worsening COVID-19 infection. Although this is an extremely rare clinical manifestation, prompt recognition can lead to appropriate early interventions and improved patient outcomes.