Episode # 190 • 10 Sept 2024
Managing Retropharyngeal Abscesses in Children
with Dr. John McClay, Dr. Gopi Shah
Nothing is more satisfying than draining an abscess, right? But when is medical management sufficient or even better? In this episode of the BackTable ENT Podcast, pediatric otolaryngologist Dr. John McClay joins host Dr. Gopi Shah to educate listeners on the diagnosis and management of pediatric retropharyngeal abscess (RPA).
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Timestamps
00:00 - Introduction
03:34 - Pathophysiology & Presentation of Retropharyngeal Abscess
09:54 - Physical Examination in the Child with Suspected Neck Abscess
17:43 - The Importance of CT Scans
31:40 - Treatment of Neck Abscesses: Antibiotics vs Surgery
37:56 - The Role of Steroids in Abscess Treatment
53:41 - Applying Value-Based Care as a Pediatric Otolaryngologist
55:44 - Recap & Final Pearls
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More about this episode
First, Dr. McClay reviews the symptoms, pathophysiology, and workup of neck abscesses (including RPA) in children. When evaluating any suspected neck abscess, he uses CT results to evaluate its precise size and location. Then, he addresses the role of surgery in treatment of neck abscesses. While many patients will improve with IV antibiotics alone, he mentions that most abscesses lateral to the carotid sheath and greater than 2 cm in size require surgical drainage. Finally, the conversation shifts to cover important topics including antibiotic selection, the role of steroids, and cost-effective care.
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