Endoscope-Assisted Parapharyngeal Space Abscess Drainage

Abstract

Background and Objectives Parapharyngeal space abscess (PPSA) may cause severe complications such as, airway obstruction, jugular thrombophlebitis, and mediastinitis unless early diagnosed and properly treated. Transoral drainage is known to reduce morbidity and hospital stays compared to the external drainage. The aim of this study is to assess the effect of endoscope when draining of PPSA via transoral approach.Subjects and Method We retrospectively reviewed charts of patients who were diagnosed with PPSA and treated surgically between February 2013 and September 2018. We included in the study 39 patients who underwent incisional drainage via transoral approach. Pateints were excluded had they undergo drainage via external approach or who treated with medication alone or operated for parapharyngeal space tumor. Thirty-nine patients were classified into two groups according to whether an endoscope was used or not when draining PPSA. We compared the hospital stays, estimated blood loss (EBL), operating time, revision rate, depth of abscess, and postoperative complications between two groups.Results Of the 39 patients [22 males (M), 17 females (F)], 13 patients (M:F=7:6) were classified as an endoscope group (EG) and 26 (M:F=15:9) as without endoscope group (WEG). The mean hospital stays of the EG and WEG were 7.6±4.6 and 9.8±4.8 days, respectively (<i>p</i>=0.188); the mean EBL of the EG and WEG were 222.2 and 254.0 mL, respectively (<i>p</i>=0.595); the mean operating time of the EG and WEG were 40.0±22.5 and 35.4±14.5 minutes, respectively (<i>p</i>= 0.457); the mean depth of PPSA of the EG and WEG were 4.5±0.9 and 4.0±0.7 c-spine level, respectively (<i>p</i>=0.043), and the revision cases of the EG and WEG were 1 and 2, respectively (<i>p</i>=1.000).Conclusion Endoscopes enabled the draining of PPSA to sit more deeply in the neck compared without it.