Abstract
Os abcessos laterofaringeos e retrofaringeos sao infeccoes potencialmente fatais, designadamente na crianca. OBJETIVO: Revisao de agentes etiologicos, achados clinicos e de exames de imagem de abcessos laterofaringeos e retrofaringeos em criancas, assim como de resultados e complicacoes do tratamento atraves de uma abordagem cirurgica trans-oral. MATERIAL E METODO: Estudo retrospectivo abrangendo 11 criancas, internadas nos ultimos 5 anos num hospital universitario terciario, com o diagnosticos de abcesso laterofaringeo (n = 8) e retrofaringeo (n = 3), com idades variando entre 0 e 12 anos. Os processos clinicos e exames de imagem foram revistos. RESULTADO: A idade media de apresentacao foi de 3.3 anos de idade. Alteracoes da mobilidade cervical(64%) e odinofagia(55%) foram os sintomas mais frequentes. Febre(64%), rigidez cervical(64%), abaulamento da parede faringea(55%),massa cervical(55%) e linfadenopatias(36%) foram os achados clinicos mais frequentes. Todos os doentes foram submetidos a drenagem cirurgia por via trans-oral nas primeiras 48 horas apos a admissao hospitalar. Cerca de 82% dos doente apresentaram melhoria do quadro clinico apos 48 horas e todos apos 72 horas, sem quaisquer complicacoes. CONCLUSAO: Considerando os bons resultados e a baixa taxa de complicacoes, o presente estudo sugere que uma antibioterapia sistemica associada a uma intervencao cirurgica atempada parece ser uma opcao valida no tratamento destes abcessos.
Highlights
Deep neck infections and subsequent formation of abscesses in the fascial planes adjacent to the pharynx still happen despite the advent of antibiotics
Their occurrence may be associated with significant rates of morbidity and mortality, mostly due to their multiplicity of complications, which includes obstruction of the airway, rupture of the abscess into the pharynx or trachea, empyema, mediastinitis, erosion of the carotid artery, jugular thrombophlebitis or thrombosis of the cavernous sinus.[1,2,3]
On physical examination the most prevalent findings were fever (64%), stiffness in the neck (64%), bulging of the oropharyngeal wall (64%), masses in the neck (55%), and lymphadenopathy (36%)
Summary
Deep neck infections and subsequent formation of abscesses in the fascial planes adjacent to the pharynx still happen despite the advent of antibiotics. Their occurrence may be associated with significant rates of morbidity and mortality, mostly due to their multiplicity of complications, which includes obstruction of the airway, rupture of the abscess into the pharynx or trachea, empyema, mediastinitis, erosion of the carotid artery, jugular thrombophlebitis or thrombosis of the cavernous sinus.[1,2,3] Diagnosis of these potentially life-threatening infections is difficult when they appear in a child, mainly because complaints and clinical signs are less clear and physical examination is more difficult to perform. The present study reviews recent experience in the management of pediatric LP and RP abscesses at our Department, with a special emphasis on the early surgical approach used in the treatment of these children
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