9) Diabetes is the most common systemic condition predisposing one to parapharyngeal abscess.
Patients with parapharyngeal abscess often present clinically with fever, sore throat and neck swelling.
Twelve had concomitant
parapharyngeal abscess and one had concomitant peritonsillar abscess.
Examination under general anesthesia revealed a left deep
parapharyngeal abscess with spontaneous rupture in the pharyngeal space.
In view of the size and position of the mass, urgent computed tomography (CT) of the neck was obtained in order to exclude a parapharyngeal abscess.
If a parapharyngeal abscess is suspected but not obvious, ultrasonography or CT of the affected area should be performed in order to facilitate surgical drainage if necessary.
The combination of a
parapharyngeal abscess and torticollis due to spastic contractions of the sternocleidomastoid muscle is an extremely rare condition.
The combination of cutaneous disease, retropharyngeal abscess, and
parapharyngeal abscess is an unusual presentation.
Parapharyngeal abscess may follow acute pharyngitis, or may come from subclinical dental infections, without preceding sore throat.
In our patient, tonsillectomy was performed because of the tonsillar hemorrhage and the suspicion of a
parapharyngeal abscess.
Some patients also had a postauricular fistula, meningitis, one or more intracranial abscesses, Bezold's abscess,
parapharyngeal abscess, spontaneous mastoid excavitation, erosion of the facial canal at various levels, destruction of dural or sigmoid plates, or sigmoid sinus hernia.
Temporal bone fibrous dysplasia and cholesteatoma leading to the development of a
parapharyngeal abscess.
