Unusual Parapharyngeal Extension of Peritonsillar Abscess to the Masticator Space: Successfully Drained by Extraoral and Intraoral Endoscopic Approaches. (May 2014)

• Record Type: Journal Article
• Authors: Hidaka, Hiroshi; Ishida, Eiichi; Suzuki, Takahiro; Matsutani, Sachiko; Kobayashi, Toshimitsu; Takahashi, Shoki
• Is Part Of: Annals of otology, rhinology & laryngology. Volume 123:Number 5(2014)
• Page Start: 333
• Page End: 337
• Publication Date: 2014-05
• Subjects: peritonsillar abscess -- masticator space -- deep neck infection -- drainage -- endoscopy; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0003489414526360
• Languages: English
• ISSNs: 0003-4894

Abstract

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.