Current issues of diagnosis and treatment of paratonsillar and parapharyngeal abscesses

Parapharyngeal abscess is a purulent inflammation of the tissue of the parapharyngeal space, often occurring as a complication of paratonsillar abscess. Parapharyngeal abscess refers to deep abscesses of the neck and is characterized by suppuration of loose tissue of the parapharyngeal space. The pathogenesis of the parapharyngeal abscess includes direct and lymphogenous spread of the inflammatory process from the primary focus. When a phlegmonous inflammatory process occurs in the parapharyngeal space, the patient experiences severe pain when swallowing, which radiates to the ear and increases when swallowing, and the patient's head is forced to tilt towards the pathological process. A painful lump appears in the angle of the lower jaw. Computed tomography is the "gold standard" for the instrumental diagnosis of parapharyngeal abscess. To date, there is no consensus on the optimal treatment strategy for patients with paratonsillar abscess complicated by parapharyngeal abscess. Certain issues, including the choice of surgical approach, remain controversial in clinical practice.