ear, nose, and throat disorders
Parapharyngeal Abscess
Introduction
A parapharyngeal abscess is a deep neck abscess. Symptoms include fever, sore throat, odynophagia, and swelling in the neck down to the hyoid bone. Diagnosis is by CT. Treatment is antibiotics and surgical drainage. The parapharyngeal (pharyngomaxillary) space is lateral to the superior pharyngeal constrictor and medial to the pterygoid muscle. This space connects to every other major fascial neck space and is divided into anterior and posterior compartments by the styloid process. The posterior compartment contains the carotid artery, internal jugular vein, and numerous nerves. Infections in the parapharyngeal space usually originate in the tonsils or pharynx, although local spread from odontogenic sources and lymph nodes may occur. Abscess swelling can compromise the airway. Posterior space abscess can erode into the carotid artery or cause septic thrombophlebitis of the internal jugular vein (Lemierre syndrome). 