Airway collapse after attempt of intubation in a patient with pharyngeal mucosal space abscess: a case report

Background: Pharyngeal mucosal space abscess is a very rare deep neck infection. Due to the anatomical relationship with the pharyngeal airway, patient may have some signs and symptoms of upper airway obstruction. Decision in airway management is important to reduce morbidity and be able to drain the abscess. Objective: To report a potential devastating airway complication in a patient with pharyngeal mucosal space abscess during intubation. Method: A patient with pharyngeal mucosal space abscess was treated and served as basis of this report. Results: After several attempts of oral intubation, the abscess was ruptured and caused acute upper airway obstruction. Surgical cricothyroidotomy was made, and converted to tracheotomy later to secure the airway. Abscess finally drained through vertical incision on the pharyngeal lumen without further complication. Conclusion: Serial aspirations should be considered in case of pharyngeal mucosal abscess to eliminate risk of ruptured abscess and airway collapse from intubation procedure. In case of successful intubation, small vertical incision on the pharyngeal wall might make adequate drainage without any scar post-operatively.