Pediatric retropharyngeal lymphadenitis: differentiation from retropharyngeal abscess and treatment implications

Otolaryngol Head Neck Surg. 2007 Feb;136(2):182-8. doi: 10.1016/j.otohns.2006.03.002.

Abstract

Objectives: Our objectives were to review the retropharyngeal anatomy, define retropharyngeal adenitis and abscess, and determine if CT may guide the clinician in treatment planning for pediatric retropharyngeal infections.

Study design and setting: A retrospective chart review and CT scan review of 30 children with retropharyngeal infections.

Results: All patients had retropharyngeal adenitis. Average volume of the low-attenuation focus in the medical treatment group was 1.2 cm3. Average volume in the surgical group was 4 cm3. Surgery patients with no purulent findings were then grouped with the medical treatment group; the average volume of the low-attenuation focus in this group was 2.2 cm3. Average volume in the group in which purulence was identified was 4.4 cm3.

Conclusion: CT can identify patients with retropharyngeal infections who have a high likelihood of being successfully treated with antibiotics alone.

Significance: CT imaging may assist in avoiding unnecessary surgical exploration.

MeSH terms

  • Child
  • Child, Preschool
  • Drainage
  • Female
  • Humans
  • Infant
  • Lymphadenitis / diagnosis*
  • Lymphadenitis / diagnostic imaging
  • Lymphadenitis / drug therapy
  • Lymphadenitis / surgery
  • Male
  • Oral Surgical Procedures
  • Retroperitoneal Space / anatomy & histology
  • Retroperitoneal Space / diagnostic imaging
  • Retroperitoneal Space / microbiology
  • Retropharyngeal Abscess / diagnosis*
  • Retrospective Studies
  • Tomography, X-Ray Computed