Endocrine Abstracts

Introduction: Parapharyngeal abscesses develop at the pharyngeal lateral wall. It is a rare infectious complication. The starting point is most often a pharyngeal infection that extends through the fibers of the upper constrictor muscles of the pharynx. The dental origin is more rare. It raises the problem of therapeutic management. The aim of this presentation was to detail the clinical diagnostic aspects of parapharyngeal abscesses in diabetics and to detail the therapeutic modalities.

Methods: We report a series of 10 patients treated in our ENT department over a period of 8 years (from 2009 to 2017).

Results: They are 8 men and 2 women, aged from 23 to 65 years old. One patient was diabetic type 1 and the other was type 2 insulin-requiring in 5 cases. The reason for consultation was painful dysphagia associated with limitation of mouth opening. Outpatient treatment with antibiotics and anti-inflammatories was given in 3 cases. The examination noted in all cases a trismus, a bad dental state and a parapharyngeal bulge. In the CT scan, parapharyngeal abscesses of varying size and extent were present. The puncture returned serosities and the bacteriological examination was negative in 2 cases. The etiological investigation had concluded to a dental origin. The treatment was medical (intravenous antibiotic therapy, optimal equilibration of diabetes), surgical (flattening of abscess by the oropharyngeal route in all cases) and treatment of the causal tooth.

Conclusion: The treatment of parapharyngeal suppurations is medico-surgical and necessarily involves the treatment of the infectious center in question. Untreated, they provide serious complications including vascular thromboses and extensive cellulite that can be life-threatening.