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The retropharyngeal space has a very complex anatomy and is located posterior to the pharynx (nasopharynx, oropharynx
and hypopharynx), larynx and trachea. The space largely contains retropharyngeal group of lymph nodes. Retropharyngeal
abscesses are deep neck space infections that occur in this space and can pose an immediate life-threatening emergency
with potential for catastrophic complications. The high mortality rate of retropharyngeal abscess is due to its association
with respiratory distress and airway obstruction, mediastinitis, aspiration pneumonitis, jugular venous thrombosis, sepsis
and sometimes erosion into the carotid artery. The incidence of the disease in gradually going down due to the widespread
availability of good antibiotics; this is also reducing a clinician’s experience in managing such cases. This is a retrospective
study of cases with the discharge diagnosis of retropharyngeal abscess treated in the past 10 years, the disease predominantly
presented with fever and pain in throat with dysphagia, poor oral intake, neck pain and sore throat. Respiratory distress was
seen in a few cases. Surgery was not performed in all the cases and in milder forms and in cases where patients refused for
surgery, conservative management was done. Patients were investigated by X-ray and CT scan and ultrasonography and once
the diagnosis of retropharyngeal abscess was established, they were managed by drainage/aspiration under general anesthesia
along with intravenous antibiotics. Early diagnosis is the key to management of these conditions to avoid morbidity and
mortality. Some interesting observations like incidence of Koch’s lesions and type of surgical intervention chosen along with
possibility of recurrence will be presented in detail.
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