What are the pathophysiologic causes of the signs and symptoms of deep neck infections?

Updated: Apr 30, 2020
  • Author: Alan D Murray, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

The signs and symptoms of a deep neck abscess develop because of the following:

  • Mass effect of inflamed tissue or abscess cavity on surrounding structures

  • Direct involvement of surrounding structures with the infectious process

For example, tonsillitis may lead to peritonsillar abscess. If not treated successfully, peritonsillar abscess may spread to the lateral pharyngeal space. From there, infection spreads to the posterior pharyngeal and prevertebral spaces and into the chest. Mediastinitis and empyema may ensue, leading to death. Alternatively, infection may spread from the lateral pharyngeal space to the contents of the carotid sheath, leading to internal jugular vein thrombosis, subacute bacterial endocarditis, pulmonary emboli, carotid artery thrombosis and cerebrovascular insufficiency, or Horner syndrome. Lateral pharyngeal space abscess alone may cause airway obstruction at the level of the pharynx. Ungkanont et al reviewed 117 children treated for deep neck infections during a 6-year period. [16] The following distribution results were revealed:

  • Peritonsillar infections (49%)

  • Retropharyngeal infections (22%)

  • Submandibular infections (14%)

  • Buccal infections (11%)

  • Parapharyngeal space infections (2%)

  • Canine space infections (2%)


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