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Asociación Mexicana de Cirugía Bucal y Maxilofacial, Colegio Mexicano de Cirugía Bucal y Maxilofacial, A.C.

2025, Number 2

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Rev Mex Cir Bucal Maxilofac 2025; 21 (2)

Retropharyngeal, parapharyngeal, and cervical abscess secondary to peritonsillar abscess: case report and literature review

Zenteno SJ, Sepúlveda QR, Matamoros RC, Parra FC, Reyes AC

Language: Spanish
References: 20
Page: 77-81
PDF size: 1931.45 Kb.


ABSTRACT

Introduction: peritonsillar abscess is a purulent collection of the soft palate located between the capsule of the palatine tonsil and the fibers of the superior pharyngeal constrictor muscle. It is a frequent complication of bacterial tonsillitis that, if not managed promptly, may spread to the deep neck spaces; the risk of severe complications increases in the presence of poorly controlled diabetes mellitus. Objective: to describe a case of peritonsillar abscess with extension to the retropharyngeal, parapharyngeal, and cervical spaces, and its resolution through an interdisciplinary surgical approach. Case report: a 67-year-old man with poorly controlled type 2 diabetes mellitus presented with odynophagia, dysphagia, and left peritonsillar swelling. Contrast-enhanced computed tomography showed a peritonsillar collection extending into the retropharyngeal and parapharyngeal spaces with airway deviation. Surgical drainage was performed via a peritonsillar approach and extended cervicotomy, with placement of an active cervical drain. Culture results guided antimicrobial adjustment, and the clinical course was favorable, with reduction of inflammatory swelling and no postoperative complications. Conclusions: in patients with diabetes mellitus, deep neck infections secondary to peritonsillar abscess require early diagnosis, contrast-enhanced imaging, timely drainage, and targeted antimicrobial therapy, together with strict metabolic control. This case reinforces the importance of an interdisciplinary approach to deep neck infections.


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