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Abscesses in relation to pharynx
Abscesses in relation to pharynx
Abscesses in relation to pharynx
Abscesses in relation to pharynx
Abscesses in relation to pharynx
Abscesses in relation to pharynx
Abscesses in relation to pharynx
Abscesses in relation to pharynx
Abscesses in relation to pharynx
Abscesses in relation to pharynx
Abscesses in relation to pharynx
Abscesses in relation to pharynx
Abscesses in relation to pharynx
Abscesses in relation to pharynx
Abscesses in relation to pharynx
Abscesses in relation to pharynx
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Abscesses in relation to pharynx

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  • 1. ABSCESSES IN RELATIONTO PHARYNX DEPT OF OTORHINOLARYNGOLOGY JJM M C DAVANAGERE
  • 2. PERITONSILLARABSCESS(QUINSY) Collection of pus in the peritonsillar space ( between capsule and superior constrictor muscle) Etiology: acute tonsillitis which arise de-novo without previous history of sore throat Chronic tonsillitis
  • 3. PERITONSILLAR ABSCESS(QUINSY) Pathogenesis: one of the tonsillar crypts usually crypta magna gets infected and sealed off leading to intra tonsillar abscess which then bursts through tonsillar capsule peritonsillitis peritonsillar abscess Organisms: streptococcus pyogenes, staph. Aureus, anaerobic organisms. Most often growth is mixed
  • 4. CLINICAL FEATURES Mostly affects adults, rarely children Mostly unilateral, rarely bilateral General symptoms : due to septicemia Fever up to 104 degree F Chills and rigor Malaise, body ache, head ache Local symptoms: Severe throat pain Painful swallowing Muffled and thick speech (hot potato voice) Foul breath Ear pain trismus
  • 5. PERITONSILLARABSCESS(QUINSY)
  • 6. EXAMINATION Tonsil, pillars and soft palate on the involved side are congested and oedematous Tonsil is pushed medially and downwards Uvula is oedematous and pushed to opposite side Bulging of anterior pillar and soft palate above the tonsil Muco pus over the tonsil Cervical lymphadenopathy torticollis
  • 7. TREATMENT Hospitalization Intra-venous fluids Intra-venous antibiotics covering both aerobic and anaerobic Analgesics Oral hygiene Incision and drainage
  • 8. COMPLICATIONS Parapharyngeal abscess Laryngeal oedema Septicemia: endocarditis, nephritis, brain abscess Pneumonitis or lung abscess Jugular venous thrombosis Spontaneous hemorrhage from carotid artery or jugular vein
  • 9. RETROPHARYNGEALABSCESS Acute retropharyngeal abscess Commonly seen in children below three years Result of suppuration of retropharyngeal lymph node ( node of rovenier) secondary to infection in adenoids, nasopharynx, paranasal sinuses or nasal cavity In adults results from penetrating injury of posterior pharyngeal wall or cervical esophagus
  • 10. RETROPHARYNGEAL ABSCESS Clinical features dysphagia, difficulty in breathing, stridor, croupy cough, torticollis On examination: bulge in the posterior pharyngeal wall usually seen on one side of midline Radiography: soft tissue lateral view of neck  widening of pre-vertebral shadow and sometimes presence of gas Treatment: incision and drainage, systemic antibiotics, tracheostomy
  • 11. RETROPHARYNGEAL ABSCESS Chronic retropharyngeal abscess: it is tubercular in nature and is result of1. Caries of cervical spine2. Tubercular infection of retropharyngeal lymph node secondary to tuberculosis of deep cervical nodes Caries of cervical spine presents centrally behind the prevertebral fascia Tuberculosis of retropharyngeal node is limited to one side of midline
  • 12. RETROPHARYNGEALABSCESS Clinical features: discomfort in throat, dysphagia, On examination: posterior pharyngeal wall shows a fluctuant swelling centrally or on one side of midline. Neck may show tuberculous lymph nodes X-ray lateral view neck is diagnostic for caries spine Treatment: incision and drainage, anti tubercular therapy
  • 13. PARAPHARYNGEALABSCESS Etiology: Pharynx: acute or chronic infection of adenoids or tonsil, bursting of peritonsillar abscess Teeth: dental abscess (lower last molar) Ear: bezold’s abscess, petrositis Infection of parotid, retropharyngeal and submaxillary space Penetrating neck injury
  • 14. PARAPHARYNGEALABSCESS Clinical features: External swelling behind the angle of jaw Prolapse of tonsil and tonsillar fossa Trismus Paralysis of cranial nerve 9, 10, 11, 12 Swelling of parotid region Fever Sore throat Odynophagia Signs of toxemia
  • 15. TREATMENT Incision And Drainage Of Abscess external drainage Systemic antibiotics analgesics
  • 16. COMPLICATION Acute laryngeal edema Thrombophlebitis of jugular vein Retropharyngeal abscess Mediastinitis Erosion of carotid artery

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