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Objective: The object was to describe 2 novel cases of peritonsillar abscess showing peculiar extension to the masticator space. Methods: The methods included clinical case records, including computed tomography and surgical approaches. Results: Both patients we encountered were suffering from systematic diseases, with case 1 involving a 75-year-old man with diabetes mellitus and case 2 involving a 90-year-old woman taking immunosuppressive medications. The abscesses were peritonsillar in origin, extending primarily to the parapharyngeal space, with unusual secondary extension to the masticator space. Extraoral drainage conducted in case 1 was useful for assessing the masticator space and surrounding spaces, but endoscopy-assisted intraoral drainage in case 2 was less invasive, obviating the need for identifying the facial nerve. Conclusions: It is important to bear in mind that patients suffering from systemic diseases may display unusual extension of deep head and neck infections, and enhanced computed tomography is a useful modality for evaluating such extensions. [ABSTRACT FROM AUTHOR]

Backgrounds: Data on risk factors for deep neck infection including descending necrotizing mediastinitis (DNM) have been limited. Using a nationwide database, the aim was identifying the factors related to patient death and delay in recovering oral intake., Methods: Data of 4949 patients were extracted from a Japanese inpatient database between 2012 and 2017. The main outcome was survival at discharge. In a subgroup analysis of the 4949 patients with survival, the second outcome was delay in the interval between admission and full recovery of oral intake., Results: Only a few factors (advanced-age, ventilation) were associated with both mortality and delayed oral dietary intake by logistic regression analyses. Conversely, several factors including DNM (adjusted-odds ratio [OR] 1.41) and repeated surgery (adjusted-OR 1.70) were significantly related only to delayed oral dietary intake., Conclusions: Although DNM was not necessarily related to mortality, patients with DNM should receive careful attention to avoid delayed oral dietary intake., (© 2021 Wiley Periodicals LLC.)