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Occult carotid pseudoaneurysm following streptococcal throat infection.

Pseudoaneurysm of the internal carotid artery (PAICA) is a rare complication of neck space infection. An 8-year-old girl presented with odynophagia (painful swallowing), trismus and left peritonsillar swelling. Abscess was suspected, but aspiration was dry. The PAICA was diagnosed on computed tomography. The aneurysm and involved left internal carotid artery were occluded endovascularly. She has made an uneventful recovery.

Aneurysm, False↗

[Parapharyngeal abscess as the cause of torticollis].

The combination of parapharyngeal abscess and torticollis in an adult on account of spastic contraction of the sterno-cleido-mastoid muscle is an extremely rare condition. The present authors have recently observed a case of this type where the diagnosis was difficult to establish. CT of the neck revealed the diagnosis with no difficulty. The indication for CT at an early stage in cases of unexplained neck infections is stressed.

Abscess↗

Transtonsillar drainage of parapharyngeal abscess.

We report a parapharyngeal abscess in an adult patient that was drained transorally by performing ipsilateral tonsillectomy and aspirating the pus through the tonsillar bed. This approach is unusual as most previous studies report the aspiration of such abscesses through the lateral pharyngeal mucosa. In addition, the majority of these studies are limited to pediatric cases. Our approach was effective and resulted in a rapid resolution of the symptoms. The management and different approaches to parapharyngeal abscess are discussed, and the literature is reviewed.

Abscess↗