# Clinical characteristics and etiological profile of retropharyngeal space abnormalities in children: a nine-year retrospective analysis

## TL;DR

This study examines how age affects the causes and treatment of retropharyngeal space issues in children, finding that younger kids are more likely to need surgery for abscesses.

## Contribution

The study identifies age-related differences in the etiology and treatment of retropharyngeal abnormalities in children.

## Key findings

- Children under 6 years old are more likely to require surgical drainage for retropharyngeal abscesses.
- Infectious causes are more common in children aged 6 and older, while congenital malformations are more prevalent in younger children.
- Clinical symptoms and imaging findings do not significantly differ between the two age groups.

## Abstract

To analyze the clinical characteristics and etiological spectrum of retropharyngeal space abnormalities in children, stratifying by age to improve diagnostic and therapeutic strategies.

We retrospectively analyzed the clinical data of 77 pediatric patients with imaging-confirmed retropharyngeal space abnormalities admitted to Wuhan Children's Hospital between January 2015 and March 2024. Patients were divided into two groups based on age: younger group (<6 years, n = 51) and older group (≥6 years, n = 26). Demographics, clinical presentations, imaging findings, etiologies, and treatment outcomes were compared between the groups using Chi-square or Fisher's exact tests for categorical data and independent samples t-tests for continuous data.

The most common presenting symptoms were fever (49.4%) and neck mass (33.8%). The primary CT finding was retropharyngeal hypodensity or fluid collection (68.8%). No significant differences were observed in sex ratio, clinical symptoms, or imaging findings between the two age groups (p > 0.05). However, children <6 years old had a significantly higher rate of requiring transoral incision and drainage for retropharyngeal abscess (23.5% vs. 3.8%, p = 0.041). Etiologically, infectious diseases were significantly more prevalent in the older group (92.3% vs. 70.6%, p = 0.030), whereas congenital malformations were a more common underlying cause in the younger group, however, this trend did not reach statistical significance (p = 0.051).

The etiology and management of pediatric retropharyngeal abnormalities are age-dependent; infectious causes dominate in children ≥6 years, while congenital malformations are key considerations in those <6 years, who are at higher risk for abscess formation requiring surgical intervention.