Deep neck abscesses-a diagnostic and therapeutic challenge


  • Aishwarya Ullal Department of ENT, St. Marys Hospital, Thodupuzha, Thodupuzha, Kerala, India
  • Arun P. Ajith Department of Radiodiagnosis, Kottayam Medical College, Kottayam, Kerala, India



Deep neck abscesses, Intraoral method of drainage, Traverse complex anatomy


Background: Deep neck space infections pose a diagnostic challenge, as they traverse complex anatomy, these patients develop devastating complications if the diagnosis is not made early.

Methods: This was a case series over a period of one year, reporting unusual presentation of deep neck abscesses. Patients were subjected to detailed history and clinical examination. Routine investigations, were done. After taking high risk consent, intra oral drainage of abscesses was done.

Results: In the present study of 30 cases age group affected was 10 to 30 years with male predominance. Peritonsillar abscesses were seen in the adolescent age groups whereas retropharyngeal space infections   were seen more in the adult population. Tuberculosis was the most common predisposing factor followed by diabetes. Dysphagia was the most common presenting symptom, followed by neck swelling. Intraoral drainage was done in 23 patients, intraoral drainage and ultrasound guided aspiration was done in 6 patients and 3 patient required emergency tracheostomy for securing of the airway.

Conclusions: Deep cervical abscesses still occur in the antibiotic era and may cause life-threatening complications.


Hasegawa J, Hidaka H, Tateda M, Kudo T, Sagai S, Miyazaki M et al. An analysis of clinical risk factors of deep neck infection. Auris Nasus Larynx. 2011;38(1):101-7.

Vieira F, Allen SM, Stocks RSM, Thompson JW. Deep neck infections. Otolaryngol Clin N Am. 2008;12:459-83.

Wills PI, Vernon RP. Complications of space infections of the head and neck. Laryngoscope. 1981;91(7):1129-36.

Mayor GP, Millan JMS, Martinez VA. Is conservative treatment of deep neck space infections appropriate? . J Head and Neck. 2001;23(2):126-33.

Emergency Imaging Assessment of Deep Neck Space Infections

Kirse DJ, Roberson DW. Surgical management of retropharyngeal space infections in children. Laryngoscope. 2001;111:1413-22.

Boscolo RP, Stellin M, Muzzi E, Mantovani M, Fuson R, Lupato V et al. Deep neck space infections: A study of 365 cases highlighting recommendations for management and treatment. Eur Arch Otorhinolaryngol. 2012;269(4):1241-9.

Huang TT, Tseng FY, Liu TC. Deep neck infection in diabetic patients: comparison of clinical picture and outcomes with nondiabetic patients. Otolaryngol Head Neck Surg. 2005;132:943-7.

Lee YQ, Kanagalingam J. Deep neck abscesses: the Singapore experience. Eur Arch Oto-rhino-laryngol. 2011;268:609-14.

Wang LF, Kuo WR, Tsai SM. Characterizations of life-threatening deep cervical space infections: a review of one hundred ninety-six cases. Am J Otolaryngol. 2003;24:111-7.

Santos Gorjón P, Blanco Pérez P, Morales Martín AC. Deep neck infection. Review of 286 cases. Acta Otorrinolaringol Esp. 2012;63:31-41.

Mathew GC, Ranganathan LK, Gandhi S. Odontogenic maxillofacial space infections at a tertiary care center in North India: a five-year retrospective study. Int J Infect Dis. 2012;16:e296-302.

Bakir S, Tanriverdi MH, Gün R. Deep neck space infections: a retrospective review of 173 cases. Am J Otolaryngol. 2012;33:56-63.

Meher R, Jain A, Sabharwal A, Gupta B, Singh I, Agarwal I. Deep neck abscess: A prospective study of 54 cases. J Laryngol Otol. 2005;119(04):299-302.

Parhiscar A, Harel G. Deep neck abscess: A retrospective review of 210 cases. Ann Otolo Rhinol Laryngol. 2001;110(11):1051-4.

Huang TT, Tseng FY, Liu TC. Deep neck infection in diabetic patients: comparison of clinical picture and outcomes with nondiabetic patients. Otolaryngol Head Neck Surg. 2005;132:943-7.

Amar YG, Manoukian JJ. Intraoral drainage: recommended as the initial approach for the treatment of parapharyngeal abscesses. Otolaryngol Head Neck Surg. 2004;130:676-80.

Choi SS, Vezina LG, Grundfast KM. Relative incidence and alternative approaches for surgical drainage of different types of deep neck abscesses in children. Arch Otolaryngol Head Neck Surg. 1997;123:1271-5.






Original Research Articles