Sign

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Sign Symptom

• Edema tenderness of submandibular space
• Uvula edema tonsil soft palate
• Bulging of lateral pharyngeal wall
• Displacement of trachea
• Trismus , Laryngeal edema
• Fever , Pain , Dysphagia ,.
• Treatment
• Penicillin (cr.) I.V.
• Surgery if infectious collection
• (You have to think about airway
  tracheotomy )

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Complication

• Laryngeal Edema
• IJV Phlebitis
• Septicemia , pyemia
• Spread of infection to other spaces
• Spread to Mediastinum
• Spread to intracranial
• Tearing of large veins

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Retropharyngeal abscess

• Anatomy
• 2-5 nodes 2-4 years Absorbed
• liquefactions of nodes
  infection
• Source of infection
• Pharynx tonsils adenoids nasopharynx M. ear
• Mastoid Eustachian tube
• Some time penetration of
• foreign body

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Treatment

• Incision
• Antibiotic
• Tracheotomy
• Care of airway

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Retropharyngeal Abscess after T.B.

• Cervical spine tuberculosis
• Retropharyngeal lymph node tuberculosis
• Sign Symptom
• Older age children adults Sore throat cough
  Mild line abscess Cervical adenopathy
• Cervical erosion
• Treatment
• Drainage (cervical)
• Remove of infected cervical lymph node
• Cervical spine treatment
• Anti tuberculosis

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Ludwig Angina

• Acute infection of mouth floor with sublingual
  space infection submental, submandibular space
  infection
• Etiology
• 80 Teeth infection,
• 20 mouth floor infection
• Anaerobe bacteria staphylococcus

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Sign Symptom

• Fever, back tongue pushing
• Spread infection, painful cellulites
• laryngeal edema breathing problem
• spread to other spaces
• Crepitation
• Trismus
• Treatment
• Antibiotic care of airway surgical treatment

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Peritonsilar abscess (Quinsy)

• Space infection between tonsilar copsul
  buccopharyngeal fascia
• Etiology
• After acute tonsilar infection
• Often is unilateral
• Often patient is young
• Often in superior pole
• Cellulites infection (flegmon)

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Sign Symptom

• Sever sore throat, fever, Trismus, Head
  each, Referral otalgia, Hoarseness, cervical
  adenitis, sever edema of tonsil
  soft palate Lateralization of uvula, halitosis,
  dyspnea if larynx pharynx problem

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Complication

• Parapharyngeal abscess
• Laryngeal edema
• Mediastinitis
• I.J.V. Thrombophlebitis
• Treatment
• Antibiotics (penicillin I.V. )
• Surgical treatment
• Tonsilectomy after 4-6 M.

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Quinsy
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Velopharyngeal insufficiency

• What is V.I.
• Results
• Hyper nasality
• Nasal
  escape
• M, N, ing

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Physiology

• Levator eminence
• Lateral pharyngeal wall
• Posterior pharyngeal wall

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Etiology

• Cleft palate Primary Secondary
• Congenital insufficiency of (occult cleft
  palate)
• After surgery
• After trauma
• Palatopharyngeal neuromuscular dysfunction
• Base of skull enlargement ( Base of skull
  anomaly, vertebral spine anomaly)
• All together

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Diagnosis

• Fluoroscopy
• Evaluation of M.E.
• Cephalometry

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Treatment

• Speech therapy
• Posterior wall augmentation
• Sphincter pharyngoplasty
• Palatoplasty
• Pushback surgery
• Inferiorly based pharyngeal flap
• Superiorly based pharyngeal flap (choice)

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• Lip carcinoma

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Sign Symptoms

• Dryness(most common)
• Pharyngeal Irritation
• Patients wants clean her/his pharynx frequently
• Brightness of P.P.W.
• Unknown etiology ? Difficult treatment
• (Smoking , Nasal obstruction)