Treatment - ABC's. Watch for rupture and aspiration. These patients may need a tracheotomy prior to drainage. Drain the wound and do not close the wound. Complications - Include hemorrhage, aspiration and extension into the chest.
Mediastinal extension is characterized by chest pain, dyspnea and persistent fever.
Initial CT scans must define the inferior extent of the spread of infection. Between the alar and prevertebral fascia from the base of the skull to the diaphragm. Usually secondary to spread of infection from the parapharyngeal space or the prevertebral space. Drainage - Similar to that described for the external approach to the retropharyngeal space. Boundaries - Compact space between the prevetebral fascia and the vertebral bodies, from the base of the skull to the coccyx.