Purpose of review To review the current literature and determine noteworthy updates in the evaluation and management of infections of the neck and pharynx in children. To better understand the role of initial surgical intervention versus medical management in children with retropharyngeal, parapharyngeal, or peritonsillar abscess. Recent findings The risk of airway compromise continues to be important in the evaluation of children with infections of the pharynx. Debate persists on the optimal initial treat- ment, medical, or surgical. Surgical intervention is recommended for children with signs of airway compromise, prevalence of complications of deep neck space infections, absence of clinical improvement after 48 h of intravenous antibiotics, abscess greater than 2.2 cm on CT imaging, age less than 4 years, or ICU admission secondary to the deep neck space infection. Based on the clinical pathway followed, newer studies show statistically significant differences in length of stay and hospital charges. In regard to PTA, transcervical ultrasound is now being used for initial evaluation to help determine which patients will benefit from incision and drainage. Summary Aside from a few identifiable risk factors, there is still a lack of consensus as to the role and timing of surgical intervention for deep
Current Treatment Options in Pediatrics – Springer Journals
Published: Apr 24, 2018
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