Role of steroids in conservative treatment of parapharyngeal and retropharyngeal abscess in children

Eur Arch Otorhinolaryngol. 2022 Nov;279(11):5331-5338. doi: 10.1007/s00405-022-07423-6. Epub 2022 Jun 29.

Abstract

Purpose: To characterize the clinical features and outcomes of pediatric patients with retropharyngeal (RPA) or parapharyngeal abscesses (PPA) managed only with medical treatment and showing the importance of early symptoms and imaging studies in the diagnosis of deep neck space infections (DNIs) in children.

Methods: A retrospective analysis of all patients diagnosed with RPA and PPA between 2007 and 2017 was performed in Hospital Universitario Central de Asturias.

Results: 30 children were identified, with 11 RPA and 19 PPA. 23 children (76.7%) were under 5 years old, and all were treated with intravenous amoxicillin/clavulanic acid and corticosteroids. Torticollis and fever were present in all patients. The mean length of hospital stay was 7.5 days. There were no complications associated.

Conclusion: DNIs can be treated in a conservative way, reserving the surgical drainage for cases with a complication associated (airway compromise, lack of response to antibiotic therapy, immunocompromised patients). Treatment with intravenous antibiotics and corticosteroids is a safe option, reducing the duration of symptoms and the length of hospital stay.

Keywords: Antibiotic treatment; Children; Deep neck space infections; Parapharyngeal abscess; Retropharyngeal abscess.

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Amoxicillin-Potassium Clavulanate Combination / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Child
  • Child, Preschool
  • Conservative Treatment
  • Drainage / methods
  • Humans
  • Neck
  • Pharyngeal Diseases* / diagnostic imaging
  • Pharyngeal Diseases* / drug therapy
  • Retropharyngeal Abscess* / diagnostic imaging
  • Retropharyngeal Abscess* / drug therapy
  • Retrospective Studies
  • Steroids / therapeutic use

Substances

  • Adrenal Cortex Hormones
  • Anti-Bacterial Agents
  • Steroids
  • Amoxicillin-Potassium Clavulanate Combination