What is the anatomy of the peritonsillar space relevant to 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

Peritonsillar space

  • This space is bounded by the tonsil medially and the superior constrictor laterally. The anterior and posterior tonsillar pillars form the remaining borders of this space.

  • Peritonsillar abscesses are the most common deep neck space abscess and represent a sequela of tonsillar infections.

  • Individuals with peritonsillar abscesses typically exhibit trismus, pain, odynophagia, drooling, a "hot potato" voice, and fever. They demonstrate uvular deviation, palatal asymmetry, and displacement of the tonsil medially. Note that the tonsillar erythema and exudates may be mild despite the presence of an abscess.

  • Patients who have had their tonsils removed effectively lose this space, but they can still develop peritonsillar pathology.

  • Peritonsillar abscesses are most commonly managed by incision and drainage or by needle aspiration. Most commonly, interval tonsillectomy is performed 4-12 weeks after resolution of the infection.

  • Peritonsillar abscesses may spread to the parapharyngeal space if not addressed promptly.


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