Between the superficial fascia and the deep layer of the deep cervical fascia. Site of superficial cellulitis of the neck usual secondary to suppuration of a lymph node. Signs of infection are obvious as these abscesses point and are fluctuant, as opposed to deep space neck infections. At T-2 the alar and middle cervical fascias fuse. Main route of spread of infection from the neck to the chest.
Infections here can easily breakthrough into the danger space which extends to the diaphragm.
Usually caused by suppuration of retropharyngeal lymph nodes receiving drainage from sinuses, adenoids and nasopharynx. Usually a complication of a URI and more common in children. The neck is usually held rigid and tilted to the uninvolved side. On oral exam the lesion is typically seen on one side, although more advanced lesions cross the midline. Treatment - ABC's.