Godse Ashwini, Abhishek Achinto, Shamanna Karthik, Puttamadaiah Gudigenahally Madaiah, Ramabhadraiah Anil Kumar
Department of ENT and HNS, Bangalore Medical College and Research Institute, Bangalore, Karnataka India.
Indian J Otolaryngol Head Neck Surg. 2025 Jan;77(1):271-278. doi: 10.1007/s12070-024-05168-8. Epub 2024 Nov 6.
The retropharyngeal space is a distinct space along the midline that extends from the skull base to the upper mediastinum. Retropharyngeal space lesions can produce significant morbidity, given their proximity to the aero-digestive tract, skull base and its ability to extend into upper mediastinum. Difficulty in assessing the retropharyngeal space by direct inspection or physical examination may cause delay in diagnosis and early intervention thus knowledge about these lesions and their effective management is essential. This is a retrospective analysis of 10 cases evaluated at the ENT Department of Bangalore Medical College and Research Institute with a diagnosis of various retropharyngeal space lesions. Retropharyngeal abscesses (6 cases) were managed surgically by incision and drainage along with antibiotics based on culture and sensitivity, out of which one was of tubercular in origin which was managed with anti tubercular drugs(ATT). Cervical osteophytes (2 cases) were managed conservatively. Retropharyngeal Myxoma(1case) was managed with intra-oral excision. Ca lung with SVC syndrome masquerading as Ludwig's angina with Retropharyngeal space collection (1 case) was managed with palliative chemoradiation. Retropharyngeal space lesions can have a wide range of differentials, all of which should be borne in mind and unnecessary intervention avoided while making a more definitive diagnosis. This study highlights the clinical presentation, effective diagnostic modalities, and treatment of various retropharyngeal space lesions. Ruling out differential diagnoses aids in the early and effective management of the retropharyngeal space pathologies, thus helping reduce morbidity and mortality.
The online version contains supplementary material available at 10.1007/s12070-024-05168-8.
咽后间隙是沿中线的一个独特间隙，从颅底延伸至上纵隔。鉴于咽后间隙病变靠近气道消化道、颅底且能够延伸至上纵隔，可导致严重的发病情况。通过直接检查或体格检查评估咽后间隙存在困难，可能会导致诊断和早期干预延迟，因此了解这些病变及其有效管理至关重要。这是一项对在班加罗尔医学院和研究所耳鼻喉科评估的10例诊断为各种咽后间隙病变的病例进行的回顾性分析。咽后脓肿（6例）通过切开引流手术治疗，并根据培养和药敏结果使用抗生素，其中1例为结核性起源，采用抗结核药物治疗。颈椎骨质增生（2例）采用保守治疗。咽后黏液瘤（1例）采用口腔内切除治疗。伪装成路德维希咽峡炎并伴有咽后间隙积液的肺癌伴上腔静脉综合征（1例）采用姑息性放化疗。咽后间隙病变可有多种不同的鉴别诊断，在做出更明确的诊断时，所有这些都应牢记在心并避免不必要的干预。本研究强调了各种咽后间隙病变的临床表现、有效的诊断方法和治疗。排除鉴别诊断有助于咽后间隙疾病的早期和有效管理，从而有助于降低发病率和死亡率。
在线版本包含可在10.1007/s12070-024-05168-8获取的补充材料。
