Association between deep neck space abscesses and internal carotid artery narrowing in pediatric patients

Authors: BETÜL EMİNE DERİNKUYU, ÖZNUR BOYUNAĞA, MELTEM POLAT, ÇAĞRI DAMAR, ANIL TAPISIZ, AYŞE GÜL ALIMLI, ÇİĞDEM ÖZTUNALI, SONER SERTAN KARA, MURAT UÇAR, HASAN TEZER

Abstract: Background/aim: Our aim was to interpret the effects of deep neck space abscesses on the adjacent carotid artery according to abscess location, as well as to determine narrowing by calculating the mean stenosis ratios.Materials and methods: Neck computed tomography scans and clinical data of 45 children with neck abscesses were evaluated retrospectively for abscess location and internal carotid artery narrowing. The lumen areas of the carotid arteries were measured from standard levels, and stenosis ratios were calculated with two different techniques. The mean stenosis ratios of each group according to abscess location were then compared with the control group.Results: Among the 45 abscesses included in the study, 51.1% (n = 23/45) were located in the peritonsillar region, 37.8% (n = 17/45) were located in the parapharyngeal-lateral retropharyngeal space, and 11.1% (n = 5/45) were in the midline retropharyngeal space. We found a statistically significant difference between the mean stenosis ratios of the ipsilateral side of the parapharyngeal-lateral retropharyngeal abscesses and the control group (P < 0.01).Conclusion: The children with parapharyngeal-lateral retropharyngeal abscesses all had narrowing in the adjacent carotid lumen to some degree. Although most of the patients had no clinical symptoms, radiologists have to be aware of this arterial complication to prevent further progress and fatal complications.

Keywords: Deep neck abscess, computed tomography, mean stenosis ratio, internal carotid artery

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