Diseases of the Parapharyngeal Space in Children

Overview

ThThe paper deals with clinical aspects of diseases of the retro- and parapharyngeal space in children. Tumoursare extremely rare. In a computerized study since 1990 only 6 published cases were found, and the authors detectedone benign lipoblastic lipoma and one Burkitt lymphoma. Contrary to adults where at this site, due to a predominanceof salivary adenomas, some 80% of all tumours are benign in children we must foresee up to 50% malignantlesions. For the variants which can be treated by surgery a transcervical approach is suitable as it does not requiremandibulotomy and is not associated with amajor postoperativemorbidity.The majority of diseases of these spacesin children are formed by inflammatory affections, i.e. abscesses, celulitis and reactive lymphadenitis. Thedifferential diagnosis is based above all on contrast CT examinations. Its sensitivity due to falsely positive andfalsely negative results does not exceed 90%. Some abscesses can therefore be verified only by aspiration punctureor surgery. In retropharyngeal and non-complicated parapharyngeal abscesses a transoral approach is preferred:an external approach is necessary in case of multiplicity of abscesses or complications which may be in up to 10%lethal. Antibiotic administration is essential. In case of a predominating polymicrobial flora with a high participationof anaerobic and beta-lactamase producing strains Augmentin is the drug of first choice.

Key words:
parapharyngeal space, children, inflammations, tumours