Transoral therapy management of a mediastinal abscess as a complication of a retropharyngeal abscess after acute tonsillitis in a 56-year-old female

An abscess of the dorsal mediastinum resulting from a retropharyngeal abscess after acute tonsillitis in adults is an extremely rare and potentially life-threatening condition. Usually these abscess formations are drained using a transthoracic or transcervical surgical approach. We present the case of a 56-year old female patient with retropharyngeal abscess extending to the dorsal mediastinum which was successfully drained using solely a transoral approach as well as intravenous antibiotic and antimycotic therapy. After initial abscess tonsillectomy, the abscess was drained up to the jugulum. The mediastinal abscess persisted for around a month yet was drained via drainage tube, which was then drained four times under sterile conditions. A control CT-scan 33 days after initial symptoms revealed complete regression of the mediastinal abscess due to the described surgical treatment combined with intravenous antibiotic and antimycotic therapy. This case shows that an oropharyngeal abscess descending down to the lower mediastinum can be successfully managed using a less-invasive transoropharyngeal approach such as intermittent drainage while closely monitoring clinical and radiological findings.

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Conflict of interest

Der Erstautor gibt keinen Interessenskonflikt an.

Publication History

Article published online:
13 May 2021