PMC5703170_01
Lateral neck X-ray demonstrating significant retropharyngeal thickening (blue arrow) with anterior displacement of airway.
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Due to worsening symptoms, his parents brought him to the nearest hospital where a lateral neck film showed a large amount of retropharyngeal thickening and airway displacement (Figure 1).
(A) Direct laryngoscopy showing displacement of supraglottic structures from significant retropharyngeal mass effect/compression with no visible airway lumen or visualization of vocal cords. An endotracheal tube with stylet or rigid ventilating bronchoscope could not be placed past this severe obstruction. (B) Direct laryngoscopy immediately after drainage of the large retropharyngeal abscess (airway previously secured with emergent tracheotomy), with grade 1 view of the larynx.
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The epiglottis could be visualized, but the posterior larynx was compressed anteriorly in such a way that the vocal cords could not even be seen (Figure 2A). Immediately following the drainage, a grade I view of the larynx was obtained (Figure 2B).