The Annals of otology, rhinology, and laryngology · 2014
Unusual parapharyngeal extension of peritonsillar abscess to the masticator space: successfully drained by extraoral and intraoral endoscopic approaches.
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Hidaka Hiroshi, Ishida Eiichi, Suzuki Takahiro, Matsutani Sachiko, Kobayashi Toshimitsu, Takahashi Shoki
Аннотация
OBJECTIVE: The object was to describe 2 novel cases of peritonsillar abscess showing peculiar extension to the masticator space.
METHODS: The methods included clinical case records, including computed tomography and surgical approaches.
RESULTS: Both patients we encountered were suffering from systematic diseases, with case 1 involving a 75-year-old man with diabetes mellitus and case 2 involving a 90-year-old woman taking immunosuppressive medications. The abscesses were peritonsillar in origin, extending primarily to the parapharyngeal space, with unusual secondary extension to the masticator space. Extraoral drainage conducted in case 1 was useful for assessing the masticator space and surrounding spaces, but endoscopy-assisted intraoral drainage in case 2 was less invasive, obviating the need for identifying the facial nerve.
CONCLUSIONS: It is important to bear in mind that patients suffering from systemic diseases may display unusual extension of deep head and neck infections, and enhanced computed tomography is a useful modality for evaluating such extensions.
METHODS: The methods included clinical case records, including computed tomography and surgical approaches.
RESULTS: Both patients we encountered were suffering from systematic diseases, with case 1 involving a 75-year-old man with diabetes mellitus and case 2 involving a 90-year-old woman taking immunosuppressive medications. The abscesses were peritonsillar in origin, extending primarily to the parapharyngeal space, with unusual secondary extension to the masticator space. Extraoral drainage conducted in case 1 was useful for assessing the masticator space and surrounding spaces, but endoscopy-assisted intraoral drainage in case 2 was less invasive, obviating the need for identifying the facial nerve.
CONCLUSIONS: It is important to bear in mind that patients suffering from systemic diseases may display unusual extension of deep head and neck infections, and enhanced computed tomography is a useful modality for evaluating such extensions.