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Sign & Symptom
Edema & tenderness of submandibular space
Uvula edema & tonsil & soft palate
Bulging of lateral pharyngeal wall
Displacement of trachea
Trismus , Laryngeal edema
Fever , Pain , Dysphagia ,…….
Treatment:
Penicillin (cr.) I.V.
Surgery if infectious collection
(You have to think about airway & tracheotomy )
Complication
 Laryngeal
Edema
 IJV Phlebitis
 Septicemia , pyemia
 Spread of infection to other spaces
 Spread to Mediastinum
 Spread to intracranial
 Tearing of large veins
Retropharyngeal abscess

Anatomy
2-5 nodes 2-4 years
Absorbed
liquefactions of nodes
infection
Source of infection :
Pharynx tonsils adenoids nasopharynx M. ear
Mastoid Eustachian tube
Some time
penetration of
foreign body
Treatment
Incision
Antibiotic
Tracheotomy
Care of airway
Retropharyngeal Abscess after
T.B.
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Cervical spine tuberculosis
Retropharyngeal lymph node tuberculosis
Sign & Symptom
Older age children & adults Sore throat & cough
Mild line abscess Cervical adenopathy
Cervical erosion
Treatment :
Drainage (cervical)
Remove of infected cervical lymph node
Cervical spine treatment
Anti tuberculosis
Ludwig Angina
Acute infection of mouth floor with
sublingual space infection & submental,
submandibular space infection
Etiology
80% Teeth infection,
20% mouth floor infection
Anaerobe bacteria & staphylococcus
Sign & Symptom
Fever,
back tongue pushing
Spread infection, painful cellulites
laryngeal edema & breathing problem
spread to other spaces
Crepitation
Trismus
Treatment:
Antibiotic care of airway surgical treatment
Peritonsilar abscess (Quinsy)
Space infection between tonsilar copsul &
buccopharyngeal fascia
Etiology
After acute tonsilar infection
Often is unilateral
Often patient is young
Often in superior pole
Cellulites
infection (flegmon)

Sign & Symptom
Sever sore throat, fever, Trismus,
Head each, Referral otalgia,
Hoarseness, cervical adenitis,
sever edema of tonsil & soft palate
Lateralization of uvula, halitosis,
dyspnea if larynx & pharynx problem
Complication
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Parapharyngeal abscess
Laryngeal edema
Mediastinitis
I.J.V. Thrombophlebitis
Treatment:
Antibiotics (penicillin I.V. )
Surgical treatment
Tonsilectomy after 4-6 M.
Quinsy
Velopharyngeal insufficiency
What is V.I.
Results:
Hyper nasality
Nasal escape
M, N, ing
Physiology
Levator
eminence
Lateral
pharyngeal wall
Posterior
pharyngeal wall
Etiology
Cleft palate
Primary
Secondary
Congenital insufficiency of (occult cleft palate)
 After surgery
 After trauma
 Palatopharyngeal neuromuscular dysfunction
 Base of skull enlargement ( Base of skull
anomaly, vertebral spine anomaly)
 All together


Diagnosis
Fluoroscopy
Evaluation
of M.E.
Cephalometry
Treatment







Speech therapy
Posterior wall augmentation
Sphincter pharyngoplasty
Palatoplasty
Pushback surgery
Inferiorly based pharyngeal flap
Superiorly based pharyngeal flap (choice)
Lip carcinoma
Sign & Symptoms


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Dryness(most common)
Pharyngeal Irritation
Patients wants clean her/his pharynx
frequently
Brightness of P.P.W.
Unknown etiology  Difficult treatment
(Smoking , Nasal obstruction&……)
‫منبع ‪ :‬مرکز تحقیقات گوش‪ ،‬گلو‪،‬بینی‪ ،‬جراحی‬
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