Infection

Epidemiology

Parapharyngeal cellulitis or abscesses are usually caused by infection originating in adjacent structures such as tonsillar, submandibular, and parotid gland abscesses. The most common site of the primary infection is an infected tonsil. An odontogenic abscess may also spread to the parapharyngeal space after involving the masticator space. Abscess may occur at any age but is more frequent in adolescents and adults.

Clinical Findings

Patients with parapharyngeal abscess usually present with fever, painful throat, and trismus that may be marked. There is often swelling of the neck, and the pharyngeal mucosa is often pushed medially.

Pathology

A variety of organisms may infect the parapharyngeal space such as Streptococcus, Staphylococcus, Pseudomonas, and Haemophilus. The initial pathological process is spreading cellulitis. If treatment is delayed, frank pus formation may ensue. Acute laryngeal edema or internal jugular thrombophlebitis that may result in subsequent septicemia may complicate the infection.

Treatment