Retropharyngeal abscess incision and drainage

Post-pharyngeal abscess occurs in the posterior pharyngeal space, more common in children from March to 3 years old, because of the rich lymphatic tissue in the posterior pharyngeal space, often due to upper respiratory tract infection, otitis media, tonsillitis, infection can be transmitted to the posterior pharyngeal space by lymph Lymph nodes can cause swollen lymphadenitis and even form abscesses. Injury to the posterior pharyngeal wall (foreign body or various traumas) causes cellulitis in the posterior pharyngeal space and forms an abscess. Tuberculous lymphadenitis and cervical tuberculosis in the posterior pharyngeal space can also cause post-pharyngeal cold abscess. Treatment of diseases: retropharyngeal abscess cervical tuberculosis Indication Post-pharyngeal abscess should be treated as soon as possible after diagnosis. Preoperative preparation Ask your medical history in detail, and learn about the history of tuberculosis in chronic abscesses. Preoperative cervical lateral x-ray film, to understand the extent of abscess, cervical vertebrae and the presence or absence of cervical bone destruction, as a reference for the choice of surgical methods. Surgical procedure 1. Sit on the back, the head is low and high, and the head is later raised. One assistant fixes his head with both hands. The other assistant uses the single-packed upper limb and trunk to support the shoulders. 2. Use a direct laryngoscope to fully expose the posterior pharyngeal abscess. First puncture the pus at the abscess bulge with a puncture needle to reduce the pressure in the abscess. Then use a tonsil knife or a pointed knife at the puncture site or below, cut about 1 to 2 cm long, then use a hemostat to expand it, and use a suction device to attract the pus. 3. Tuberculous abscess can be puncture through the oral cavity for multiple punctures, and then injected streptomycin and isoniazid solution into the abscess. If the puncture is ineffective, it can be used as a neck-side incision and drainage. The method is that the patient is supine, the shoulder under the pillow, the head is biased to the healthy side, and the skin of the affected neck is routinely disinfected. Incision area skin and subcutaneous anesthesia with 2% procaine infiltration, on the posterior edge of the sternocleidomastoid muscle, from the plane of the mandibular angle, a 5~6 cm incision was made downward, and the skin and subcutaneous tissue were cut. The shallow deep fascia is separated, and the sternocleidomastoid muscle and its deep carotid sheath are pulled forward to reach the posterior pharyngeal space. Use your fingers to find out the abscess, and then use a hemostat to separate the soft tissue, you can enter the abscess. The drainage port should be enlarged as much as possible, and the finger should be inserted into the abscess cavity to explore and separate the possible adhesive cavity. If there is free bone, it should be removed, the abscess should be washed with streptomycin and isoniazid solution, and the drainage strip should be placed. The cut does not have to be stitched

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