후인두농양의치료에대한고찰 정지성 이동욱 연제엽. Adequate Management of Retropharyngeal Abscess. Ji-Seong Jeong, MD, Dong Wook Lee, MD and Je-Yeob Yeon, MD

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1 KISEP Head and Neck Korean J Otolaryngol 004;4: 후인두농양의치료에대한고찰 충북대학교의과대학이비인후과학교실 정지성 이동욱 연제엽 Adequate Management of Retropharyngeal Abscess Ji-Seong Jeong, MD, Dong Wook Lee, MD and Je-Yeob Yeon, MD Department of Otolaryngology, College of Medicine, Chungbuk National University, Cheongju, Korea ABSTRACT Background and Objectives:The incidence of retropharyngeal abscess has been decreased with use of antibiotics, but it still causes critical complications such as airway obstruction, aspiration pneumonia, mediastinitis, or sepsis. For this reason, early diagnosis and proper management of retropharyngeal abscess should be undertaken as soon as possibile. The treatment includes maintaining airway, performing surgical drainage, and administering antibiotics; but there are no definite guidelines for treating patients with retropharyngeal abscess, nor a golden rule for the correct surgical approach. Subjects and Method:A retrospective analysis of patients with retropharyngeal abscess who were treated at the Chungbuk University Hospital from 99 to 00 was performed. We analized general symptoms, signs, causing factors, and causing bacteria. We also analized the treatment outcome and selected approaches from the surgically treated patients. Results:The general symptoms of retropharyngeal abscess were sore throat, fever, dyspnea, with the most common cause being the upper airway infection. Bacteriologically, hemolytic streptococcus was the most common bacteria among aerobes and bacteroides was the most common bacteria among anaerobes. However, in most cases, both aerobe and anaerobes were cultured at the same time. Among 8 cases, 6 cases were treated conservatively with antibiotics and surgical interventions were performed in cases, which included cases of transoral and case of transcervical approach. Conclusion:Retropharyngeal abscess can be treated with either conservative or surgical treatment according to initial abscess size.the abscess size which is greater than cm is prefered to be treated surgically,and transoral approach is a useful way of dealing with less invasive procedure. (Korean J Otolaryngol 004;4:899-90) KEY WORDS:Retropharyngeal abscess Antibiotics Transoral approach. 899

2 후인두농양의치료에대한고찰 후인두농양의일반증상및증후 - 후인두농양의유발원인 Table. Symptoms and signs of retropharyngeal abscess Symptoms & signs Children n8 Adults n0 Sore throat Fever Dyspnea Poor oral intake Post. neck pain Numbers are not mutually exclusive Table. Etiologic factors of retropharyngeal abscess Etiology Acute tonsillitis Upper respiratory infection Retropharyngeal tuberculous lymphadenitis Pharyngeal foreign body Underlying disease DM HT LC Tb DM c Tb 4 Children Adult 원인균 - - 보존적또는수술적치료의결과 - - Table. Bacteriological study in retropharyngeal abscess Isolated bacteria Children n6 Adult n6 Aerobes Streptococcus 4 4 Staphylococcus Klebsiella Anaerobes Bacteroides species Peptococcus No growth Numbers are not mutually exclusive 900 Korean J Otolaryngol 004;4:899-90

3 정지성외 Table 4. Management according to the retropharyngeal abscess size Size of abscess Under the cm n Over the cm n Methord of treatment Conservative 6 Surgical Duration of IV antibiotics use days Conservative 9.5 Surgical * Duration of postoperative IV antibiotics use * Complication IVIntravenous, Excluding transcervically approached patient 수술적치료시경구개적접근과경경부적접근의비교 수술적치료시배출관 (drain) 유치와일차봉합술시행간의예후차이및합병증 - 90

4 후인두농양의치료에대한고찰 Korean J Otolaryngol 004;4:899-90

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