Ojiri H, Tada S, Ujita M, Ariizumi M, Ishii C, Mizunuma K, Fukuda K
Department of Radiology, Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan.
Eur Radiol. 1998;8(6):955-9. doi: 10.1007/s003300050495.
The aim of this study was to determine the pathway of infrahyoid extension of the oropharyngeal abscess considering the anatomy of the fascial spaces by cross-sectional imaging. CT scans and MR images were retrospectively reviewed in ten patients with known infrahyoid extension of oropharyngeal abscesses (eight with acute tonsillitis, two with acute phlegmonous oropharyngitis). In seven of eight patients tonsillar abscesses descended along the deep cervical fascia converging on the hyoid bone and further accumulated in the anterior cervical space through which extension to the mediastinum took place in four patients. In seven patients the abscesses involved the retropharyngeal space at the infrahyoid neck. In two of these seven patients the abscesses directly extended down into the upper mediastinum through the retropharyngeal space. In one patients of the seven mediastinal spread of an abscess occurred through the posterior cervical space, not through the retropharyngeal space. Cross-sectional imaging is valuable in the evaluation of deep neck abscesses and the pathway of spread. The anterior cervical space in the infrahyoid neck is important for mediastinal extension of pharyngeal abscesses.
本研究的目的是通过横断面成像，结合筋膜间隙的解剖结构，确定口咽脓肿舌骨下延伸的途径。对10例已知口咽脓肿有舌骨下延伸的患者（8例急性扁桃体炎，2例急性脓性口咽炎）的CT扫描和MR图像进行回顾性分析。8例患者中的7例，扁桃体脓肿沿颈深筋膜向下蔓延，汇聚于舌骨，并进一步积聚在前颈部间隙，4例患者由此延伸至纵隔。7例患者的脓肿累及舌骨下颈部的咽后间隙。这7例患者中的2例，脓肿通过咽后间隙直接向下延伸至上纵隔。7例患者中有1例脓肿通过颈后间隙而非咽后间隙发生纵隔扩散。横断面成像在评估深部颈部脓肿及其扩散途径方面具有重要价值。舌骨下颈部的前颈部间隙对咽脓肿向纵隔的延伸很重要。
