What procedures are used in airway management of a retropharyngeal abscess (RPA)?

Updated: Jan 08, 2021
  • Author: Joseph H Kahn, MD; Chief Editor: Gil Z Shlamovitz, MD, FACEP  more...
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Answer

See the list below:

  • Endotracheal intubation

    • Securing the airway may be required if the patient with retropharyngeal abscess is exhibiting signs of impending upper airway obstruction. Endotracheal intubation may be attempted, but it may be difficult because of distortion of the upper airway. [8]

    • Prophylactic intubation for a patient with retropharyngeal abscess but without respiratory distress generally is not indicated unless an interhospital transfer is planned.

  • A literature review did not reveal the role of surgical or needle cricothyrotomy in RPA, but If a patient with signs of upper airway obstruction cannot be intubated, a surgical or needle cricothyrotomy may be required; the procedure may be difficult to perform, however, due to tissue edema and distortion.

  • A tracheostomy may be required as definitive airway management in patients with retropharyngeal abscess and respiratory distress, but the procedure may be difficult to perform due to tissue edema and distortion. [9]

  • Airway management in the operating room is preferred, with surgeon and anesthesiologist present, if clinical condition and time allow it. [8]


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