A parapharyngeal abscess is a deep neck space

abscess An abscess is a collection of pus that has built up within the tissue of the body. Signs and symptoms of abscesses include redness, pain, warmth, and swelling. The swelling may feel fluid-filled when pressed. The area of redness often extends b ...

of the

parapharyngeal space The parapharyngeal space (also termed the lateral pharyngeal space), is a potential space in the head and the neck. It has clinical importance in otolaryngology due to parapharyngeal space tumours and parapharyngeal abscess developing in this area ...

(or pharyngomaxillary space), which is lateral to the

superior pharyngeal constrictor muscle The superior pharyngeal constrictor muscle is a muscle in the pharynx. It is the highest located muscle of the three pharyngeal constrictors. The muscle is a quadrilateral muscle, thinner and paler than the inferior pharyngeal constrictor muscle a ...

and medial to the masseter muscle. This space is divided by the styloid process into anterior and posterior compartments. The posterior compartment contains the

carotid artery Carotid artery may refer to: * Common carotid artery, often "carotids" or "carotid", an artery on each side of the neck which divides into the external carotid artery and internal carotid artery * External carotid artery, an artery on each side of t ...

, internal jugular vein, and many nerves.

Signs and symptoms

Symptoms include fever, sore throat, painful swallowing, and swelling in the neck. An anterior space abscess can cause lockjaw (spasm of jaw muscle), and hard mass formation along the angle of the mandible, with medial bulging of the tonsil and lateral pharyngeal wall. A posterior space abscess causes swelling in the posterior pharyngeal wall, and lockjaw is minimal. Other structures within the carotid sheath may be involved, causing rigors, high fever, bacteremia, neurologic deficit, or a massive haemorrhage caused by carotid artery rupture.

Cause

Infection can occur from: * Pharynx: acute and chronic infection of tonsil and adenoids * Teeth: dental infection occurs from lower last molar tooth * Ear:

Bezold's abscess Bezold's abscess is an abscess deep to the sternocleidomastoid muscle where pus from mastoiditis erodes through the cortex of the mastoid part of the temporal bone, medial to the attachment of sternocleidomastoid, extends into the infratemporal fos ...

and petrositis * Other space: infection of parotid retropharyngeal space * External trauma: penetrating injuries of neck, injection of local anaesthetic

Epidemiology

Parapharyngeal abscess is more common in male than the female gender. Any age group can develop a parapharyngeal abscess but it is most commonly seen in children and adolescents. Adults who are immunocompromised are also at high risk.

References

{{reflist Otorhinolaryngology