Neck phlegmon
| Classification according to ICD-10 | |
|---|---|
| L03.8 | Phlegmon in other locations |
| ICD-10 online (WHO version 2019) | |
A throat phlegmon is a diffuse, usually very rapidly spreading, bacterial inflammation of the soft tissue of the throat.
Origin and course
The starting point of a neck phlegmon is usually an acute inflammation of the tonsils , also via a peritonsillar abscess or an inflamed regional lymph node . Throat injuries or impaled foreign bodies can also lead to a throat phlegmon, as can purulent inflammation of the parotid gland , root inflammation of the rear molars and even purulent inflammation of the outer and middle ear .
The inflammation penetrates the parapharyngeal space , the connective tissue space on the side of the throat, and spreads from here down into the soft tissues of the neck. In particular, it also spreads along the vascular sheath of the neck, which often results in an infected thrombosis of the iugular vein with the risk of sepsis . As the disease progresses, the inflammation reaches the mediastinum , resulting in life-threatening mediastinitis . If left untreated, a throat phlegmon can lead to death in a few days.
Diagnosis and symptoms
With considerable general symptoms with a rising fever and a severe feeling of illness, there is initially a pressure-sensitive swelling in the area of the angle of the jaw with pain-related torticollis, which quickly spreads over the entire side of the neck and also to the face. On the inside there is often a protrusion of the side wall of the pharynx that extends into the hypopharynx and can lead to swallowing difficulties and breathing difficulties.
The diagnosis is made based on the typical symptoms; a CT , MR or ultrasound examination can help.
treatment
A throat phlegmon requires immediate surgical intervention. High doses of antibiotic treatment, the connective-tissue of the neck, in particular the vascular sheath, exposed and by the contribution of plates and tubes drained . This is followed by rinsing with disinfecting solutions and a gradual shortening of the inserted tabs.
literature
- E. Lüscher: Textbook of nose and throat medicine , Springer-Verlag, Vienna 1956
- Hans-Peter Zenner: Practical Therapy of Ear, Nose and Throat Diseases , Schattauer, Stuttgart 1993
- Hans Heinz Naumann: Differential diagnostics in ear, nose and throat medicine , Georg Thieme Verlag, Stuttgart 1990
