BV Manjula*

Senior Consultant and Head of the Department of ENT and Head and Neck Surgery, Bangalore Baptist Hospital, India

*Corresponding Author: BV Manjula, Senior Consultant and Head of the Department of ENT and Head and Neck Surgery, Bangalore Baptist Hospital, India.

Received: July 15, 2021; Published: August 28, 2021

Abstract

Background: Deep neck spaces include prevertebral, danger and retropharyngeal spaces. Imaging cannot differentiate between these various fascial planes. A hematoma in these potential spaces due to any reason can compress the airway leading to stridor, dyspnea, neck pain and dysphagia. Most of these hematomas resolve within 2 weeks but few would require intervention depending on severity of symptoms.

Case Description: A 53 years old female patient was mechanically ventilated and tracheostomized for severe COVID-19 illness. She developed throat pain, swallowing difficulty and difficulty in neck movements, which were noticed after she was shifted to the ward. She was referred to the ENT department for endoscopic evaluation and imaging which suggested a large retropharyngeal collection. She underwent intraoral aspiration and drainage of hematoma after which her symptoms resolved.

Conclusion: Individualized approach is needed for these rare conditions and sometimes a simple procedure may be sufficient to address a major, possibly life threatening condition.

Keywords: Retropharyngeal Hematoma; Prevertebral Space; Dysphagia; Airway Obstruction; Anticoagulants

References

1. Kuhn JE and Graziano GP. “Airway compromise as a result of retropharyngeal hematoma following cervical spine injury”. Journal of Spinal Disorders3 (1991): 264-269.
2. Penning L. “Prevertebral hematoma in cervical spine injury: incidence and etiologic significance”. AJR: American Journal of Roentgenology3 (1981): 553-561.
3. Shaw CB., et al. “Traumatic Retropharyngeal Hematoma: A Case Report”. Otolaryngology- Head and Neck Surgery4 (1995): 485-488.
4. Myssiorek D and Shalmi C. “Traumatic Retropharyngeal Hematoma”. Archives of Otolaryngology - Head and Neck Surgery9 (1989): 1130-1132.
5. Cohen AF and Warman SP. “Upper airway obstruction secondary to warfarin-induced sublingual hematoma”. Archives of Otolaryngology - Head and Neck Surgery6 (1989): 718-720.
6. Ophir D and Bartal N. “Retropharyngeal hematoma following fish-bone ingestion”. Ear, Nose and Throat Journal7 (1988): 528-530.
7. Daniello NJ and Goldstein SI. “Retropharyngeal hematoma secondary to minor blunt head and neck trauma”. Ear, Nose and Throat Journal1 (1994): 41-43.
8. O'Neill JV., et al. “Retropharyngeal hematoma secondary to minor blunt trauma in the elderly patient”. Journal of Otolaryngology1 (1977): 43-46.

Citation

Citation: BV Manjula. “Retropharyngeal Space Hematoma in a Patient with Severe COVID-19 Illness".Acta Scientific Otolaryngology 3.9 (2020): 56-59.

Copyright

Copyright: © 2020 BV Manjula. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.