Retropharyngeal Abscess: Seven-Year Review - Clinical Presentation, Diagnosis and Management

Retropharyngeal Abscess
Vol. 4 No. 2 : 2009 (84-90)

Abdul Fattah AW Abdul Fattah AW
Marina MB Marina MB
Mazita A Mazita A
Muhammad Razif MY Muhammad Razif MY
Primuharsa Putra SHA Primuharsa Putra SHA

Abstract
This was a retrospective study of operative records between 2000 – 2007 from two ear, nose and throat (ENT) referral centers in Malaysia to review demographic patterns, clinical presentations and management of retropharyngeal abscess (RPA). Our case series comprised of eight patients with five females and three males with a median age at presentation of 47 years. Comorbid factor in this series was diabetes mellitus, with four patients having diabetes. There were three cases of fish bone ingestion. The commonest presentation was dysphagia or odynophagia. None of them had fever. All patients were treated with broad spectrum intravenous antibiotics (IV)  and drainage was performed for the abscess. Four patients underwent transoral drainage with three having the cervical approach and one having spontaneous rupture.  All patients recovered well from the infection and only one patient passed away due to septicaemia.In conclusion, patients with retropharyngeal abscess may present with vague symptoms of sore throat, odynophagia without fever due to partial antibiotics treatment. A correct diagnosis should be made so that adequate treatment can be given to prevent mortality.
Keywords : dysphagia, odynophagia, Retropharyngeal abscess, transoral drainage,
Abstrak
Ini adalah satu kajian retrospektif dengan merujuk kepada rekod-rekod pembedahan dari tahun 2000 hingga 2007. Rekod- rekod pembedahan tersebut diperolehi  daripada dua buah pusat rujukan Otorinolaringologi (ORL) Malaysia. Kajian ini bertu­juan untuk menilai struktur demografi, presentasi klinikal,dan rawatan bagi pesakit-pesakit yang mengalami jangkitan abses retrofaring. Terdapat lapan orang pesakit dalam kajian ini, lima perempuan dan tiga lelaki dengan median umur semasa men­dapat rawatan iaitu 47 tahun. Faktor ko-mobiditi di dalam kajian ini adalah diabetis mel­itus, di mana empat orang pesakit menghidap diabetis. Tiga pesakit tertelan tulang ikan. Presentasi yang paling sering dialami oleh pesakit adalah sakit ketika menelan atau kesukaran untuk menelan. Walaubagaimanapun, tiada pesakit yang mengalami demam. Kesemua pe­sakit dirawat dengan antibiotik intravena dan pembedahan. Em­pat pesakit menjalani pembedahan mengeluarkan abses melalui rongga mulut, tiga pesakit menjalani pem­bedahan mengeluarkan abses melalui tepi leher dan abses pe­cah secara spontan terjadi kepada seorang pesakit. Kesemua pesakit sembuh dari jangkitan tersebut ke­cuali seorang sahaja yang meninggal dunia disebabkan septisemia.
Kata Kunci : Abses retrofaring, rawatan transoral, sakit menelan, sukar menelan,

Correspondance Address
Dr. Marina Bt Mat Baki, Department of Otorhinolaryngology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur. Fax: 603-91737840. Email: marinadrent@gmail.com