Surgical Management of Retropharyngeal Infection: Report of Two Cases

Introduction: Deep neck infection is a serious condition and may lead to life-threatening complications if not diagnosed and treated early. The clinical presentation is widely variable and early symptoms often do not reflect disease severity.

Objectives: This study presents two cases of retropharyngeal infection that failed treatment with only antibiotics and had to be managed surgically through distinct approaches.

Resumed Report: Case 1 is a 14-year-old male patient diagnosed with a 4-cm retropharyngeal abscess, treated initially with oral antibiotics with minimal clinical and radiological improvement, resulting in complete resolution of symptoms after surgery association with parenteral antibiotic for 14 days. The patient underwent endonasal surgical approach with drainage of pus and evolved with rapid improvement. Case 2 is a 9-year-old child presenting bulging of left tonsil and a retropharyngeal image of 7 cm at a CT-scan. Patient underwent surgical drainage through an oral approach without elimination of pus. However, the orifice formed in surgery provided a spontaneous drainage pathway. Patient improved significantly after the procedure.

Conclusion: Use of antibiotics alone for treatment of deep neck infection has not demonstrated a favorable outcome. Surgical drainage of the abscess associated with parenteral antibiotic therapy has provided a good clinical course and rapid reversal of symptoms. Therefore, surgery in cases of retropharyngeal space infection remain as the basis of treatment, with different routes of access to the infected site.