A parapharyngeal abscess is a deep neck space abscess of the parapharyngeal space (or pharyngomaxillary space), which is lateral to the superior pharyngeal constrictor muscle and medial to the

masseter muscle In human anatomy, the masseter is one of the muscles of mastication. Found only in mammals, it is particularly powerful in herbivores to facilitate chewing of plant matter. The most obvious muscle of mastication is the masseter muscle, since it ...

. This space is divided by the styloid process into anterior and posterior compartments. The posterior compartment contains the carotid artery,

internal jugular vein The internal jugular vein is a paired jugular vein that collects blood from the brain and the superficial parts of the face and neck. This vein runs in the carotid sheath with the common carotid artery and vagus nerve. It begins in the poste ...

, 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 In anatomy, the mandible, lower jaw or jawbone is the largest, strongest and lowest bone in the human facial skeleton. It forms the lower jaw and holds the lower teeth in place. The mandible sits beneath the maxilla. It is the only movable bone ...

, 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 and petrositis * Other space: infection of parotid

retropharyngeal space The retropharyngeal space (abbreviated as "RPS") is a potential space and deep compartment of the head and neck situated posterior to the pharynx. The RPS is bounded anteriorly by the buccopharyngeal fascia, posteriorly by the alar fascia, and la ...

* 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 Immunodeficiency, also known as immunocompromisation, is a state in which the immune system's ability to fight infectious diseases and cancer is compromised or entirely absent. Most cases are acquired ("secondary") due to extrinsic factors that a ...

are also at high risk.

References

{{reflist Otorhinolaryngology