Transsphenoidal Parapharyngeal Abscess Complicating Pansinusitis: A Rare Aetiology That Should Not Be Overlooked
Abcès Parapharyngé Par Voie Trans-Sphénoïdale Compliquant Une Pansinusite : Une Étiologie Rare à ne Pas Méconnaître
DOI:
https://doi.org/10.5281/zenodo.18622887Keywords:
Pansinusite, Abcès Parapharyngé, Brèche SinusienneAbstract
RÉSUMÉ
Les sinusites se compliquent surtout d’atteintes orbitaires ou intracrâniennes ; les abcès parapharyngés sont presque toujours d’origine amygdalienne. Nous rapportons le cas d’un adolescent de 14 ans, sans comorbidité, admis pour syndrome infectieux rhinogène, tuméfaction parotidienne droite et trismus. La tomodensitométrie a révélé une pansinusite avec brèche de la paroi sphénoïdale inférieure communiquant directement avec un abcès parapharyngé droit. Un drainage endobuccal de l’abcès a été réalisé en urgence, associé à une méatotomie moyenne, une éthmoïdectomie et une sphénoïdotomie bilatérales. L’évolution a été rapidement favorable, avec disparition de l’abcès au contrôle scanographique à trois mois. Ce cas illustre une complication rare de sinusite – l’abcès parapharyngé par propagation trans-sphénoïdale – et rappelle l’importance d’une imagerie systématique devant toute suspicion.
ABSTRACT
Sinusitis usually leads to orbital or intracranial complications; parapharyngeal abscesses almost always arise from tonsillar or dental infections. We report the rare case of a 14‑year‑old boy with no medical history, admitted for rhinogenic infectious syndrome, right parotid swelling, and trismus. Computed tomography revealed pansinusitis with a breach of the inferior sphenoid sinus wall directly communicating with a right parapharyngeal abscess. Emergency endobuccal drainage of the abscess was performed, together with bilateral middle meatal antrostomy, ethmoidectomy, and sphenoidotomy. Postoperative recovery was rapid; three‑month follow‑up CT showed complete resolution of the abscess. This case illustrates an exceptional complication of sinusitis – parapharyngeal abscess due to trans‑sphenoidal spread – and underscores the need for systematic imaging whenever rhinogenic symptoms are accompanied by lateralized cervicofacial signs.
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Copyright (c) 2026 Diallo MD, Thiam NF, Niang C, El Idrissi Z, Diouf K
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