38 year old male underwent a tooth extraction at a local dental camp. After few days he develops fever and trismus. On local examination, there is a swelling at the angle of jaw . He has a poor oral hygiene and tonsils were pushed medially .No membranous covering or discharging sinus were seen around tonsils. Most likely diagnosis in this condition would be ?
Parapharyngeal abscess/ Pharyngomaxillary /L ateral pharyngeal space Located between lateral pharyngeal wall(medially) and styloid process with its muscular attachments (laterally) Styloid process along with its muscle attachements divides the paraphyrangeal space into Anterior and Posterior compaments Anterior compament infection: Prolapse of tonsil(tonsil is pushed medially ) Trismus (Due to spasm of medial pterygoid muscle) Swelling behind the angle of jaw(close to anterior 1/3rd of Sternocleidomastoid muscle ) Posterior compament infection: Bulge of pharynx Paralysis of cranial nerve IX,X,XI and XII Swelling of parotid region Other options: Retropharyngeal abscess:Present on 1 side of midline and swelling on posterior pharyngeal wall Peritonsilar abscess/(quinsy): Collection of pus in the peritonsillar space only tonsil is pushed medially and no swelling / bulge at angle of jaw
Peritonsillar abscess
Retropharyngeal abscess
Parapharyngeal abscess
Ludwig's angina
Hypopharynx