retropharyngeal

Retropharyngeal describes anatomical structures located behind the pharynx. The retropharyngeal space is a potential space in the deep neck that lies between the buccopharyngeal fascia anteriorly and the alar fascia posteriorly. It extends from the skull base to the superior mediastinum and communicates with other deep cervical spaces. A posterior compartment, sometimes called the danger space, lies behind the alar fascia and can extend downward to the diaphragm.

In children, the retropharyngeal space contains retropharyngeal lymph nodes, which can become enlarged during upper respiratory infections. These nodes typically involute with age. Infections or inflammation involving this area can lead to retropharyngeal cellulitis or abscess, a condition that can threaten airway patency and spread to adjacent neck spaces or the mediastinum.

Clinical presentation typically includes fever, neck pain or stiffness, dysphagia or odynophagia, muffled voice, and sometimes neck extension. In severe cases, airway compromise is possible. Diagnosis is guided by imaging, with lateral neck radiographs showing widening of the prevertebral space; computed tomography or magnetic resonance imaging provides detailed assessment of the extent and involvement of surrounding structures.

Management depends on severity. Mild cases may be treated with appropriate antibiotics and close monitoring. Abscess formation often requires drainage, and airway management may be necessary in advanced cases. Early evaluation by clinicians is important to prevent progression and potential complications.