---
title: "Retropharyngeal Abscess"
description: "Detailed Anatomy of Retropharyngeal Space, and clinical features, radiological diagnosis, and treatment of Retropharyngeal Abscess."
source: "The ENT Resident"
author: "Dr. Mausumi Das"
canonical_url: "https://www.theentresident.com/ent-notes-lectures/retropharyngeal-abscess"
categories: ["Neck"]
video: "https://www.youtube.com/watch?v=B_6drtRZHvU"
image: "https://media.theentresident.com/og-images/retropharyngeal-abscess.png"
---

# Retropharyngeal Abscess

Detailed Anatomy of Retropharyngeal Space, and clinical features, radiological diagnosis, and treatment of Retropharyngeal Abscess. Watch the full video lecture on YouTube: https://www.youtube.com/watch?v=B_6drtRZHvU

## Retropharyngeal Space and Abscess

### 📍 Anatomy of the Retropharyngeal Space

- **Location:**  

  The retropharyngeal space is a **potential space** situated between:
  - **Buccopharyngeal fascia** (middle layer of deep cervical fascia) anteriorly
  - **Alar fascia** (part of the deep layer of deep cervical fascia) posteriorly

>What is the other name for Retropharyngeal Space?

### 🧱 Boundaries of the Retropharyngeal Space

| Boundary | Anatomical Landmark |
| --- | --- |
| Superior | Base of the skull |
| Inferior | Level of T4 vertebra / Carina (bifurcation of trachea) where alar and buccopharyngeal fascia fuse |
| Anterior | Buccopharyngeal fascia covering pharyngeal constrictors |
| Posterior | Alar fascia |
| Lateral | Carotid sheath and its contents |

- The space is divided by a **midline fibrous raphe** into two lateral compartments called the **spaces of Gillette**.

### 🧬 Contents of the Retropharyngeal Space

- **Retropharyngeal (Rouvière's) lymph nodes**
- Fat and loose areolar tissue
- Pharyngeal plexus of veins and nerves
- Communicates **anterolaterally** with **parapharyngeal spaces** on both sides

---

### 🦠 Retropharyngeal Abscess

### 🧫 Etiology of Retropharyngeal Abscess

- **In Children (< 3 years):**  

  Suppuration of **retropharyngeal lymph nodes** secondary to infection in:
  - Adenoids
  - Nasopharynx
  - Posterior nasal sinuses
  - Nasal cavity

- **In Adults:**  
  - **Penetrating injury** of posterior pharyngeal wall or cervical esophagus
  - Rarely, spread from **acute mastoiditis** through petrous bone

---

### ⚠️ Clinical Features of Retropharyngeal Abscess

- Dysphagia
- Breathing difficulty
- Stridor and croupy cough
- Torticollis
- Unilateral bulge in posterior pharyngeal wall

---

### 🩻 Radiological Diagnosis of Retropharyngeal Abscess

**📸 X-ray (Lateral View of Neck – Soft Tissue)**

- **Widening of prevertebral shadow**
- May show presence of **air/gas** in soft tissue
- Straightening of cervical spine
- Air-fluid level may be seen

>What is the normal width of pre vertebral soft tissue shadow?

#### 🧠 CT Scan (Contrast-Enhanced)

- Confirms **extent of abscess**
- Detects **spread below hyoid**
- Identifies associated **parapharyngeal abscess**

---

### 💉 Treatment of Retropharyngeal Abscess

1. Incision and Drainage (I&D)

>What is the site of incision for **I&D** in Retropharyngeal abscess?

2. Antibiotics

3. Tracheostomy 

>What are the indications of Tracheostomy in Retropharyngeal abscess?

---

### ⚠️ Complications of Retropharyngeal Abscess

- Hemorrhage
- Laryngeal spasm
- Bronchitis
- Septicemia
- Metastatic abscess
- Internal jugular vein thrombosis
- Carotid artery erosion
- Aspiration pneumonia

---

## About This Note

This free ENT note on Retropharyngeal Abscess was written by Dr. Mausumi Das and is paired with a corresponding video lecture.

Canonical page of this note: https://www.theentresident.com/ent-notes-lectures/retropharyngeal-abscess

When citing or referencing this content, please credit The ENT Resident and link to the canonical page above.

## Related Notes by Category

- Neck: https://www.theentresident.com/ent-notes-lectures/category/neck.md

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The ENT Resident is an educational website and resource library created by Dr. Mausumi Das (MS ENT) for ENT residents, ENT postgraduates preparing for exams, and MBBS students.

Dr. Mausumi Das writes the notes, draws the diagrams, and records the lectures herself.

Browse all ENT notes and lectures on The ENT Resident: https://www.theentresident.com/ent-notes-lectures.md

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The ENT Resident provides educational material for medical learning and revision. It does not provide patient-specific medical advice, diagnosis, or emergency care, and it is not a substitute for evaluation by a qualified healthcare professional.

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