Although rare, RPAs are serious, with the potential for significant morbidity and mortality if not detected early. They account for 12% to 22% of all deep space infections in the neck.[4]Wang LF, Tai CF, Kuo WR, et al. Predisposing factors of complicated deep neck infections: 12-year experience at a single institution. J Otolaryngol Head Neck Surg. 2010 Aug;39(4):335-41.
http://www.ncbi.nlm.nih.gov/pubmed/20642996?tool=bestpractice.com
The peak incidence in children is at 3 to 5 years of age.[1]Jennings CR. Surgical anatomy of the neck. In: Gleeson M, Hilbert JS, eds. Scott-Brown's otorhinolaryngology, head and neck surgery. 7th ed. London: Hodder Arnold; 2008:1744-45.[5]Grisaru-Soen G, Komisar O, Aizenstein O, et al. Retropharyngeal and parapharyngeal abscess in children - epidemiology, clinical features and treatment. Int J Pediatr Otorhinolaryngol. 2010 Sep;74(9):1016-20.
http://www.ncbi.nlm.nih.gov/pubmed/20598378?tool=bestpractice.com
[6]Woods CR, Cash ED, Smith AM, et al. Retropharyngeal and parapharyngeal abscesses among children and adolescents in the United States: epidemiology and management trends, 2003-2012. J Pediatric Infect Dis Soc. 2016 Sep;5(3):259-68.
https://academic.oup.com/jpids/article/5/3/259/2580082
http://www.ncbi.nlm.nih.gov/pubmed/26407249?tool=bestpractice.com
The condition is increasing in incidence in adults.[2]Gaglani MJ, Edwards MS. Clinical indicators of childhood retropharyngeal abscess. Am J Emerg Med. 1995 May;13(3):333-6.
http://www.ncbi.nlm.nih.gov/pubmed/7755832?tool=bestpractice.com
Children are more frequently affected by the condition because they have an increased frequency of upper respiratory tract infections and oropharyngeal trauma, as well as the tendency toward suppuration in the retropharyngeal lymph nodes. These nodes tend to regress after the age of 4 years. RPAs are more common in males than in females, with 53% to 62% of cases occurring in males.[2]Gaglani MJ, Edwards MS. Clinical indicators of childhood retropharyngeal abscess. Am J Emerg Med. 1995 May;13(3):333-6.
http://www.ncbi.nlm.nih.gov/pubmed/7755832?tool=bestpractice.com
[5]Grisaru-Soen G, Komisar O, Aizenstein O, et al. Retropharyngeal and parapharyngeal abscess in children - epidemiology, clinical features and treatment. Int J Pediatr Otorhinolaryngol. 2010 Sep;74(9):1016-20.
http://www.ncbi.nlm.nih.gov/pubmed/20598378?tool=bestpractice.com
[7]Wang LF, Kuo WR, Tsai SM, et al. Characterizations of life-threatening deep cervical space infections: a review of one hundred ninety-six cases. Am J Otolaryngol. 2003 Mar-Apr;24(2):111-7.
http://www.ncbi.nlm.nih.gov/pubmed/12649826?tool=bestpractice.com
[8]Philpott CM, Selvadurai D, Banerjee AR. Paediatric retropharyngeal abscess. J Laryngol Otol. 2004 Dec;118(12):919-26.
http://www.ncbi.nlm.nih.gov/pubmed/15667676?tool=bestpractice.com
In a 10-year review of RPA cases, 70% of patients were African-American, 25% were white, and 5% were Hispanic.[7]Wang LF, Kuo WR, Tsai SM, et al. Characterizations of life-threatening deep cervical space infections: a review of one hundred ninety-six cases. Am J Otolaryngol. 2003 Mar-Apr;24(2):111-7.
http://www.ncbi.nlm.nih.gov/pubmed/12649826?tool=bestpractice.com
However, a 2004 study found 43% of cases in African-American people, 54% in white people, 1% in Hispanic people, and 1% in biracial people.[8]Philpott CM, Selvadurai D, Banerjee AR. Paediatric retropharyngeal abscess. J Laryngol Otol. 2004 Dec;118(12):919-26.
http://www.ncbi.nlm.nih.gov/pubmed/15667676?tool=bestpractice.com