INFRAHYOID SPREAD OF DEEP NECK ABSCESS - ANATOMICAL CONSIDERATION

The aim of this study was to determine the pathway of infrahyoid exten sion of the oropharyngeal abscess considering the anatomy of the fasci al spaces by cross-sectional imaging. CT scans and MR images were retr ospectively reviewed in ten patients with known infrahyoid extension o f oropharyngeal abscesses (eight with acute tonsillitis, two with acut e phlegmonous oropharyngitis). In seven of eight patients tonsillar ab scesses descended along the deep cervical fascia converging on the hyo id bone and further accumulated in the anterior cervical space through which extension to the mediastinum took place in four patients. Tn se ven patients the abscesses involved the retropharyngeal space at the i nfrahyoid neck. In two of these seven patients the abscesses directly extended down into the upper mediastinum through the retropharyngeal s pace. In one patients of the seven mediastinal spread of an abscess oc curred through the posterior cervical space, not through the retrophar yngeal space. Cross-sectional imaging is valuable in the evaluation ol deep neck abscesses and the pathway of spread. The anterior cervical space in the infrahyoid neck is important for mediastinal extension of pharyngeal abscesses.