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Retrospective review of 33 cases of paediatric retropharyngeal and parapharyngeal infections and a proposed algorithm for managing future cases

Published online by Cambridge University Press:  14 July 2025

Michael Fitzsimons Open the ORCID record for Michael Fitzsimons [Opens in a new window] ,
Seamus Boyle Open the ORCID record for Seamus Boyle [Opens in a new window] ,
Michael Colreavy ,
Siobhan Hoare ,
Stephen Kieran ,
Eimear Phelan ,
Patrick Sheehan ,
Natalija Snovak  and
Colleen Heffernan
Michael Fitzsimons*
Affiliation:
Department of Otolaryngology, Children’s Health Ireland at Temple Street, Dublin, Ireland
Seamus Boyle
Affiliation:
Department of Otolaryngology, Children’s Health Ireland at Temple Street, Dublin, Ireland
Michael Colreavy
Affiliation:
Department of Otolaryngology, Children’s Health Ireland at Temple Street, Dublin, Ireland
Siobhan Hoare
Affiliation:
Department of Radiology, Children’s Health Ireland at Temple Street, Dublin, Ireland
Stephen Kieran
Affiliation:
Department of Otolaryngology, Children’s Health Ireland at Temple Street, Dublin, Ireland
Eimear Phelan
Affiliation:
Department of Otolaryngology, Children’s Health Ireland at Temple Street, Dublin, Ireland
Patrick Sheehan
Affiliation:
Department of Otolaryngology, Children’s Health Ireland at Temple Street, Dublin, Ireland
Natalija Snovak
Affiliation:
Department of Otolaryngology, Children’s Health Ireland at Temple Street, Dublin, Ireland
Colleen Heffernan
Affiliation:
Department of Otolaryngology, Children’s Health Ireland at Temple Street, Dublin, Ireland
*
Corresponding author: Michael Fitzsimons; Email: michael.fitzsimons31@gmail.com
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Abstract

Objective

Retropharyngeal and parapharyngeal infections can be managed surgically or conservatively. A trial of medical treatment before considering computed tomography (CT) imaging may be appropriate.

Methods

This is a retrospective review of patients with retropharyngeal and parapharyngeal infections between October 2022 and April 2023. Descriptive and statistical analysis compared surgically and conservatively managed patients.

Results

There were 33 patients (median age 58 months). CT imaging was acquired for 30 of 33 patients (90.9 per cent) and 25 had a CT scan within 24 hours of presentation. Fourteen patients (42.4 per cent) were managed surgically. The mean duration of antibiotics for surgically and conservatively managed patients was not significantly different (19.9 vs 21.4 days, p = 0.73). Larger lesions were observed on the CT scans of surgically treated patients (22.8 vs 15.6 mm, p = 0.01).

Conclusion

Management of paediatric retropharyngeal and parapharyngeal infections can be surgical or conservative. We propose a management algorithm that allows an initial trial of intravenous antibiotics before CT imaging for selected patients.

Keywords

pediatricsretropharyngeal abscessneck

Information

Type
Main Article
Information
The Journal of Laryngology & Otology , First View , pp. 1 - 7
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

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Footnotes

Michael Fitzsimons takes responsibility for the integrity of the content of the paper

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