Abcessos parafaríngeos na criança: estudo retrospectivo de 5 anos / Parapharyngeal abscess in children: five year retrospective study

Os abcessos laterofaríngeos e retrofaríngeos são infecções potencialmente fatais, designadamente na criança. Objetivo: Revisão de agentes etiológicos, achados clínicos e de exames de imagem de abcessos laterofaríngeos e retrofaríngeos em crianças, assim como de resultados e complicações do tratamento através de uma abordagem cirúrgica trans-oral. Material e método: Estudo retrospectivo abrangendo 11 crianças, internadas nos últimos 5 anos num hospital universitário terciário, com o diagnósticos de abcesso laterofaríngeo (n = 8) e retrofaríngeo (n = 3), com idades variando entre 0 e 12 anos. Os processos clínicos e exames de imagem foram revistos. Resultado: A idade média de apresentação foi de 3.3 anos de idade. Alterações da mobilidade cervical(64 por cento) e odinofagia(55 por cento) foram os sintomas mais frequentes. Febre(64 por cento), rigidez cervical(64 por cento), abaulamento da parede faríngea(55 por cento),massa cervical(55 por cento) e linfadenopatias(36 por cento) foram os achados clínicos mais frequentes. Todos os doentes foram submetidos a drenagem cirurgia por via trans-oral nas primeiras 48 horas após a admissão hospitalar. Cerca de 82 por cento dos doente apresentaram melhoria do quadro clinico após 48 horas e todos após 72 horas, sem quaisquer complicações. Conclusão: Considerando os bons resultados e a baixa taxa de complicações, o presente estudo sugere que uma antibioterapia sistémica associada a uma intervenção cirúrgica atempada parece ser uma opção válida no tratamento destes abcessos.

Lateropharyngeal and retropharyngeal abscesses are potentially life threatening infections in children AIM: To review the etiologic, clinical, and imaging signs of lateropharyngeal and retropharyngeal abscesses in children as well as treatment-outcomes and complications using a surgical trans-oral approach. Method: Retrospective analysis of 11 children, hospitalized in the last 5 years, with a diagnosis of lateropharyngeal (n = 8) and retropharyngeal (n = 3) abscesses, ages ranging from 0 to 12 years old. Charts and CT scans were reviewed. Result: The average age of presentation was 3.3 years. Neck stiffness (64 percent) and odynophagia (55 percent) were the most common symptoms. Fever (64 percent), stiff neck (64 percent), bulging of the oropharyngeal wall (55 percent), mass in the neck (55 percent) and lymphadenopathy (36 percent) were the most prevalent physical findings. All these patients were submitted to surgical drainage using a trans-oral approach in the first 48 hours after admission. About 82 percent of the patients showed improvement after 48 hours, and 100 percent after 72 hours, without any complications. Conclusion: Based on the good clinical outcomes and low incidence of complications, the present study suggests that antibiotic therapy complemented with a timely surgical treatment, is a valid treatment option in refractory parapharyngeal abscesses.

Parapharyngeal abscess in children: five year retrospective study.

UNLABELLED: Lateropharyngeal and retropharyngeal abscesses are potentially life threatening infections in children AIM: To review the etiologic, clinical, and imaging signs of lateropharyngeal and retropharyngeal abscesses in children as well as treatment-outcomes and complications using a surgical trans-oral approach. METHOD: Retrospective analysis of 11 children, hospitalized in the last 5 years, with a diagnosis of lateropharyngeal (n = 8) and retropharyngeal (n = 3) abscesses, ages ranging from 0 to 12 years old. Charts and CT scans were reviewed. RESULT: The average age of presentation was 3.3 years. Neck stiffness (64%) and odynophagia (55%) were the most common symptoms. Fever (64%), stiff neck (64%), bulging of the oropharyngeal wall (55%), mass in the neck (55%) and lymphadenopathy (36%) were the most prevalent physical findings. All these patients were submitted to surgical drainage using a trans-oral approach in the first 48 hours after admission. About 82% of the patients showed improvement after 48 hours, and 100% after 72 hours, without any complications. CONCLUSION: Based on the good clinical outcomes and low incidence of complications, the present study suggests that antibiotic therapy complemented with a timely surgical treatment, is a valid treatment option in refractory parapharyngeal abscesses.