Retropharyngeal soft tissues

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Retropharyngeal soft tissues

• A. Kolbenstvedt
• Department of radiology
• Rikshospitalet, Oslo

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Normal soft tissues
Lusted and Keats. PP lt 0.3 x c.4
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Bulging retropharyngeal soft tissues
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Prevertebral soft tissues

• Spine
• Ant. long. ligament
• Prevertebral muscles
• Prevertebral fascia
• Retropharyngeal space
• Pharyngobasilar fascia
• Constrictor muscle
• Mucosal membrane

Pernkopfs anatomic atlas
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Retropharyngeal expansion from spine and muscle

• Osteophytes
• Metastatic destruction
• Primary bone tumor
• Spondylitis
• Fracture
• Traumatic hematoma
• Retropharyngeal tendinitis

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Osteophytes
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Primary and secondary tumor
Metastasis
Chordoma
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Spondylitis
Origin from cervical spine
Origin from thoracic spine
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Retropharyngeal tendinitt
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Calcified tendon
Tomogr. 3days
10. day
Haun al. AJR 1978
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Retropharyngeal tendinitis
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CT of retropharyngeal tendinitis
Acute phase
Follow-up at 6 weeks
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Contents of retropharyngeal space

• Fat
• Lymph nodes with
• afferent and efferent lymph and blood vessels

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Retropharyngeal fat
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Retropharyngeal lymph nodesRouviere 1938
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Retropharyngeal space abnormalities

• Lymphadenitis
• Abcess, edema
• Lymph node metastases
• Lipoma
• Emphysema
• Vascular malformations ?

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Retropharyngeal fat
Lipoma
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Effect of retropharyngeal expansion on
parapharyngeal fat
Harnsberger
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Retropharyngeal lymph node metastasis
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Retropharyngeal lymphadenitis
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Differential diagnosis
Arterial thrombosis
Venous trombosis
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Retropharyngeal abscess
DeWeese and Saunders Otolaryngology
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Edema and abscess
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Spread of retropharyngeal abscess
From retropharygeal phlegmone to mediastinal
abscess in 5 days
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Perforation with air leakage
a
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Retropharyngeal emphysema
e
e
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Intraluminal air
d
ach
d
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Prevertebral abnormalities originating in
pharynx/oesophagus

• Pharyngeal posterior wall carcinoma
• Hypertrophy cricopharyngeal muscle
• Diverticula
• Achalasia
• Foreign bodies

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(No Transcript)
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Posterior wall pharyngeal cancer
After treatment
Before treatment
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Posterior wall carcinoma
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Foreign bodies
P
Potato
Metallic
Chicken bone
Meat
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Retropharyngeal vascular structures

• Medially located carotid arteries
• Vascular malformations
• Metastases with increased vascularity
• Hyperemia
• Hematoma

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Retropharyngeal carotids
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Aneurysm in medical carotid
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Vascular malformations
Glue in venous outflow from AV-malformation
T2-MR of venous malf.
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Vascular retropharyngeal metastasis
Metastasis from renal carcinoma
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(No Transcript)
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Medial extension of carotid space
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Retropharyngeal haematoma
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Prevertebral abnormalities due to ingrowth of
tumors

• Thyroid
• Parathyroid
• Trachea
• Neurogenic

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Benign thyroid goiter
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Thyroid carcinoma
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Neurinoma
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Neurofibromatosis
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Retropharyngeal abnormalities

• Spine
• Prevertebral muscles and tendons
• Retropharyngeal space
• Vascular structures and nerves
• Foreign bodies
• Pharyngeal muscles and mucous membrane
• Ingrowth from other organs