Parapharyngeal abscess with tracheal deviation

Yee, Allison M; Christensen, Dallin N; Waterbrook, Anna L.; Amini, Richard

doi:10.1007/s11739-017-1634-8

Cited by 2 publications

(2 citation statements)

References 5 publications

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“…Treatment of pharyngeal abscesses includes high-dose, IV antibiotic therapy covering both gram-positive aerobes and anaerobes [19] . Appropriate antibiotic choices are penicillins with beta-lactamase inhibitors (eg piperacillin-tazobactam, ampicillin-sulbactam), clindamycin, or high dose penicillin with metronidazole (as penicillin monotherapy would be insufficient coverage) [20] . Incision and drainage by an otolaryngologist is often required for complete resolution of these infections based on the extent of the abscess and degree of airway compromise [ 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Deep neck abscess after intubation trauma: a case report

Kaul¹,

Nayak²,

Jacoby³

et al. 2022

Radiology Case Reports

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Significant injuries from endotracheal intubation are exceedingly rare but can lead to life-threatening complications, such as pharyngeal perforation. This type of perforation can result in abscess formation and airway compromise. Risks for this complication include operator skill and intubation in emergent situations. This case report details a 59-year-old male who underwent elective septoplasty with bilateral nasal turbinate reduction. The procedure required general anesthesia induction and endotracheal intubation. He developed a gradually enlarging right-sided neck mass with associated fevers, neck pain, odynophagia, and dysphonia. He presented to the emergency department on postoperative day 5 and was diagnosed with a right-sided, prevertebral space abscess with airway mass effect secondary to pharyngeal perforation. He was admitted for operative management, intravenous antibiotics, and was successfully treated. While significant injury from endotracheal intubation is rare, it can result in infection and threaten airway patency. Emergency physicians must recognize pharyngeal perforation as a potential source of infection following instrumentation of the pharynx. This case has been reported to increase awareness of the potential for such injury.

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Section: Discussionmentioning

confidence: 99%

Deep neck abscess after intubation trauma: a case report

Kaul¹,

Nayak²,

Jacoby³

et al. 2022

Radiology Case Reports

View full text Add to dashboard Cite

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“…Airway management is challenging in patients presenting with parapharyngeal abscess. First, medial bulging of the pharyngeal wall due to deep space pathology and edema from soft tissue inflammation distorts airway anatomy [9], modifies tissue planes [4], decreases tissue mobility [10], and impairs visualization and localization of the glottis [6]. Second, trismus, decreased interdental gap, and narrowing of the oropharyngeal isthmus [4] limit accessibility for intubation and subsequent administration of general anesthesia might conversely trigger airway closure and prevent intubation [11,12].…”

Section: Introductionmentioning

confidence: 99%

Experiential learning in simulated parapharyngeal abscess in breathing cadavers

et al. 2021

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Purpose Education in airway management is a fundamental component of anesthesiology training programs. There has been a shift towards the use of simulation models of higher fidelity for education in airway management. The goal of this study was to create a novel cadaveric model of a simulated parapharyngeal abscess with features of a difficult airway such as distorted anatomy and narrow airway passages presenting as stridor. The model was further assessed for its suitability for enhanced experiential learning in the management of difficult airways. Methods Cadaver heads were modified surgically to simulate parapharyngeal abscess. Airtight torso of the cadaver was connected to an Oxylog ventilator to simulate respiratory movements-the opening and closing of air channels with breaths in a patient with parapharyngeal abscess. Advanced airway workshop facilitators conducted directed one-to-one learning, and provided feedback to participants. A paper-based feedback was obtained from 72 participants on their confidence level, and the realism, attractiveness, beneficial, and difficulty levels of the simulated cadaveric models. Results The modified cadavers were reliable in simulating difficult airways. The majority of participants (91%) reported an increase in confidence level for management of the difficult airway after the experience with the modified cadavers and found the models realistic (93%), attractive (92%), beneficial (93%), and difficult (85%). Conclusions Surgical modifications of cadavers to simulate difficult airways such as parapharyngeal abscess with edema and stridor can be incorporated into advanced airway management courses to enhance experiential learning in airway management by awake fibreoptic intubation, and promote patient safety.

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Parapharyngeal abscess with tracheal deviation

Cited by 2 publications

References 5 publications

Deep neck abscess after intubation trauma: a case report

Deep neck abscess after intubation trauma: a case report

Experiential learning in simulated parapharyngeal abscess in breathing cadavers

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