Abstract Although the antibiotic era has lessened the incidence and improved the prognosis of neck suppurations, surgical drainage remains the definitive method of treatment. In 1941, Weintraub1 divided the retropharyngeal area into five separate spaces, namely, the paired right and left prevertebral spaces, the paired right and left peripharyngeal spaces, and, lying between the latter two, the unpaired postvisceral space. Infection in the postvisceral space may descend without any interfering barrier into the mediastinum, but infection in the prevertebral and peripharyngeal spaces is not likely to descend into the mediastinum. I. Postvisceral Space This space is located between the buccopharyngeal and the prevertebral fasciae and communicates freely with the posterior mediastinum. Furstenberg2 describes a simple technique to drain this space and the mediastinum: An incision is made along the anterior border of the sternomastoidFig. 1.—The relationship of the pharyngeal space abscesses to the normal structures. Reproduced with permission References 1. Weintraub, J. D.: A New Anatomic and Functional Systematization of the Connective Tissues of the Neck , Arch. Otolaryng. 33:1, 1941.Crossref 2. Furstenberg, A. C.: Acute Mediastinal Suppuration , Tr. Am. Laryng. Rhin. & Otol. Soc. 35:210, 1929. 3. Tschiassny, K.: The "Juxtapharyngeal" Spaces as Carriers and Barriers of Suppurations: A New Anatomical Classification , Cincinnati J. Med. 26:337, 1945. 4. Mosher, H. P.: The Submaxillary Fossa Approach to Deep Pus in the Neck , Tr. Am. Acad. Ophthal. 34:19, 1929. 5. Tschiassny, K.: Ludwig's Angina, an Anatomic Study of the Role of the Lower Molar Teeth in Its Pathogenesis , Arch. Otolaryng. 38:485, 1943. 6. Tschiassny, K.: Ludwig's Angina, a Surgical Approach Based on Anatomical and Pathological Criteria , Ann. Otol., Rhin. & Laryng. 56:937, 1947.
A.M.A. Archives of Otolaryngology – American Medical Association
Published: Dec 1, 1959