Ultrasound-Guided Transoral Drainage of a Challenging Parapharyngeal Abscess: A Case Report

TL;DR

A 43-year-old woman with a severe throat abscess was successfully treated using ultrasound-guided drainage through the mouth, avoiding more invasive surgery.

Contribution

This case report demonstrates the effectiveness of ultrasound-guided transoral drainage for a challenging parapharyngeal abscess.

Findings

Ultrasound-guided intraoral drainage successfully treated a deep parapharyngeal abscess unresponsive to antibiotics.

The patient recovered well and was discharged within six days following the procedure.

CT scans are essential for diagnosing and monitoring parapharyngeal abscesses.

Abstract

Parapharyngeal space infections are uncommon but associated with significant morbidity and mortality. Early surgical drainage remains the mainstay of treatment; however, the optimal surgical approach continues to be debated. Management typically involves either an external (transcervical) approach or a transoral route.

We present the case of a 43-year-old woman with a deep parapharyngeal abscess unresponsive to empirical antibiotic therapy who presented with dysphagia, fever, and left cervical swelling. Computed tomography (CT) confirmed the presence of the abscess. Ultrasound-guided intraoral drainage was performed, followed by intravenous antibiotic therapy. The patient had an uneventful recovery and was discharged on the sixth hospital day. Parapharyngeal abscess is the second most common deep neck space infection after peritonsillar abscess. Accurate diagnosis relies on clinical evaluation and radiologic imaging, with CT considered the gold standard for both initial diagnosis and ongoing monitoring.

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