Servicio de Otorrinolaringología, Hospital Universitario Virgen de la Victoria, Málaga, España.
Servicio de Otorrinolaringología, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, España.
Acta Otorrinolaringol Esp (Engl Ed). 2021 Mar-Apr;72(2):71-79. doi: 10.1016/j.otorri.2020.01.005. Epub 2020 May 30.
Retropharyngeal abscess is a serious condition. Its rare occurrence, thus sharing symptoms with other processes, make it a diagnostic challenge for the clinician. Therefore, it is critical to make an early diagnosis to prevent delaying treatment and avoid complications.
To gain knowledge of the epidemiology, pathogenesis, clinical manifestations, the most commonly implicated microorganisms, the type of treatment used, morbidity and mortality of retropharyngeal abscesses at a tertiary institution over the last 25 years.
A retrospective study was conducted by reviewing medical records of all patients diagnosed with retropharyngeal abscess in a single centre between 1 January 1990 and 31 February 2016. Thirty-three patients were included in our study. Data such as personal history, present illness, diagnoses and treatment procedures were collected from the medical records.
The incidence during the years of study was 0.2 cases/100 000 inhabitants/year. Personal medical histories most often associated were alcoholism, smoking, diabetes and obesity. The most common aetiology found was impaction of a foreign body (especially fishbone). The most common presenting symptoms were odynophagia and neck pain accompanied by fever. Preventive tracheotomy was performed in the initial management of the patient in 9 cases (27%). The most frequent complication was descending necrotizing mediastinitis. Surgical drainage of the abscess was required in 27 patients (82%), especially with external approaches (17 cases). Two patients had sequelae: paralysis of unilateral vocal cord and Horner's syndrome. No mortality was observed in the patients of the study.
Retropharyngeal abscesses must be considered medical-surgical emergencies as they are likely to produce serious complications. We must pay attention to the warning symptoms such as odynophagia and cervical pain, associated or otherwise with dyspnoea, stridor, trismus, and neck stiffness. Advances in diagnostic and therapeutic procedures together with advances in critical care have been a key factor in improving the prognosis and mortality of these patients.
咽后脓肿是一种严重的疾病。由于其罕见的发生，且与其他疾病有相似的症状，这给临床医生的诊断带来了挑战。因此，早期诊断至关重要，以避免延误治疗并防止出现并发症。
了解在过去 25 年中，一家三级医院的咽后脓肿的流行病学、发病机制、临床表现、最常见的相关微生物、所采用的治疗类型、发病率和死亡率。
通过回顾 1990 年 1 月 1 日至 2016 年 2 月 31 日期间在一家中心确诊的所有咽后脓肿患者的病历，进行了一项回顾性研究。我们的研究纳入了 33 名患者。从病历中收集了个人病史、现病史、诊断和治疗程序等数据。
研究期间的发病率为 0.2 例/100 000 居民/年。最常与个人病史相关的是酗酒、吸烟、糖尿病和肥胖。最常见的病因是异物（尤其是鱼骨）嵌顿。最常见的表现症状是咽痛和颈痛，伴有发热。在患者的初始治疗中，有 9 例（27%）进行了预防性气管切开术。最常见的并发症是下行坏死性纵隔炎。27 例患者（82%）需要进行脓肿引流，特别是采用外部途径（17 例）。有 2 例患者出现了后遗症：单侧声带麻痹和霍纳氏综合征。研究中的患者没有死亡。
咽后脓肿必须被视为医疗急症，因为它们可能导致严重的并发症。我们必须注意警示症状，如咽痛和颈痛，无论是否伴有呼吸困难、喘鸣、牙关紧闭和颈部僵硬。诊断和治疗程序的进步以及重症监护的进步是改善这些患者预后和死亡率的关键因素。
