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Article in Japanese

The efficacy of contrast-enhanced computed tomography for children with parapharyngeal abscess

Yosuke NISHIO1), Yoshihiko KAWANO1), Shinya HARA1)

Parapharyngeal abscess, characterized by an abscess formation in deep neck space, is relatively rare, and accounts for about 15% of deep neck abscesses. It can progress to life-threatening complications, due to its anatomical characteristics. Therefore, determining a treatment choice and assessing whether the initial treatment is therapeutically effective or not is essential. This paper considered the efficacy of contrast-enhanced computed tomography (cCT) for the judgement of therapeutic effectiveness for parapharyngeal abscess in children.
Four patients with parapharyngeal abscess were reviewed retrospectively from April 2013 to October 2016. All of the cases were treated conservatively with antibiotics. Although body temperature, leucocyte count and CRP improved over time in all cases, the fourth patient finally received surgical drainage because of the volume expansion of abscess space on the 2nd cCT imaging. There were no volume expansions of abscess space on the 3rd cCT imaging.
It was concluded that performing the 2nd cCT is important for judging of therapeutic effectiveness of conservative treatment for parapharyngeal abscess. However, a 3rd cCT is not necessarily required, thus patients can avoid unnecessary radiation exposure.

1) Department of Pediatrics, TOYOTA Memorial Hospital

Key words deep neck abscess, parapharyngeal abscess, contrast-enhanced computed tomography, conservative treatment, surgical drainage
Received September 4, 2017
Accepted January 11, 2018

30 (1):10─17,2018