Retropharyngeal Space

spatium retropharyngeum

The retropharyngeal space is the potential space between the posterior pharyngeal wall (covered by buccopharyngeal fascia) anteriorly and the alar fascia posteriorly. It extends from the skull base superiorly to T1-T2 inferiorly where the alar and pretracheal fasciae fuse. Laterally it is bounded by the carotid sheaths. It contains loose areolar tissue and lateral retropharyngeal lymph nodes of Rouviere.

Region: Neck

Clinical Relevance

Clinical Notes

Retropharyngeal abscess in children typically results from suppuration of the retropharyngeal lymph nodes (Rouviere nodes) following upper respiratory infection. In adults it results from foreign body penetration or cervical spine injury. It presents with fever, drooling, dysphagia, and a bulging posterior pharyngeal wall. CT with contrast distinguishes cellulitis from abscess. Drainage is transorally under direct vision for abscesses above C3 or externally for lower lesions. Risk of rupture causing aspiration pneumonia.

Pathology

Common Injuries & Conditions

Retropharyngeal Abscess in Children

Suppuration of the retropharyngeal lymph nodes following tonsillitis or pharyngitis produces a retropharyngeal abscess with drooling, high fever, neck stiffness, and a smooth midline posterior pharyngeal bulge; CT confirms the abscess collection and transoral drainage under general anaesthesia is performed before spontaneous rupture with aspiration.