What is the role of radiography in the workup 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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See the list below:

  • Lateral neck radiography

    • These tests may reveal soft tissue swelling in the prevertebral region. Lateral neck radiographs can also demonstrate radiopaque foreign bodies, subcutaneous air, air fluid levels, and erosion of the vertebral bodies.

    • Prevertebral soft tissue thickening greater than 7 mm over C2 or greater than 14 mm in children and 22 mm in adults over C6 is highly suggestive of a retropharyngeal process.

  • Mandible series

    • When a dental source of the infection is suggested, a Panorex can help evaluate the patient for a dental abscess.

    • Particular attention should be given to the second and third mandibular molars because the apices of these teeth extend below the mylohyoid line, giving them access to the submandibular space.

  • Chest radiography: To evaluate the mediastinum, check for subcutaneous air or pneumomediastinum, displacement of the air stripe, or concurrent pneumonia suggesting aspiration.

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