Retropharyngeal abscess is not common but is important in understanding the fascial spaces of the head and neck. The retropharyngeal space extends from the anterior face of the basi-occiput down-ward through the prevertebral space into the posterior mediastinum, laterally the retropharyngeal space is continuous with the parapharyngeal space. In infants and young children, there are lymph nodes in the retropharyngeal space which atrophy or regress by young adult life. Therefore, retropharyngeal abscess is seen almost exclusively in infants and young children. Their afferents drain adjacent muscles and bones, the nasal cavities, accessory sinuses, the nasal part of pharynx, middle or internal ears and the auditory tubes, their efferents pass to the superior deep cervical nodes. A special type, chronic type of retropharyngeal abscess, the ""cold abscess"" of tuberculosis (Pott's disease), is seen at any age. 

Case Report
This 57-year-old moderate developed and nourished housewife Mrs. Lee who was referred to out-patient department because of dyspnea, fever, dysphagia, redness and swelling on the right lateral neck, chest discomfort and limitation on movement of the neck at April 27, 1965. The above mentioned symptoms and signs were noted for 7 days, and those were aggrevated the more for 2 days. 

Urinalysis and stool examination : negative. B.P. 120/80, Temp. 38°C, Pulse 90 , Resp. 25. After the admission, operation of lateral incision of the right deep cervical abscess and internal approach of the retropharyngeal abscess, was performed with the Trendelenburg's position under the general endotracheal anesthesia. A lot of amount of greenish yellow pus was evacuated and revealed hemolytic streptococcus, it's very sensitive to terramycin, tetracyclin and albamycin, but also moderately sensitive to the streptomycin, kanamycin and leukomycin. After the operation, rubber drain which was inserted into the retropharyngeal space, was exchanged and irrigated with saline solution daily. Lipiodol was injected through the Nelaton catheter into the retropharyngeal space and it's spread to the right cervical abscess cavity and to posterior mediastinal abscess cavity ((Fig.2), 3, 4 & 5). In the X-ray for sinus cavity, both maxillary sinuses were revealed diffusely cloud and chest PA showed negative finding. She was treated as above mentioned procedure for 16 days and her general condition and local signs were improved. About five months after discharge, she was rechecked of her general and local condition with laboratory examination and X-ray study. Her general and local condition revealed no definite abnormality and also the lipiodol of the mediastinum disappeared. 

Following Results Summarized : 
1) Acute retropharyngeal abscess followed by contralateral deep cervical abscess and mediastinal abscess. 2) The neck lateral view of X-ray, and chest lateral view after lipiodol injection through retropharyngeal incised wound are most significant in the diagnostic view point of the acute retropharyngeal abscess. 3) It's the most effective treatment of acute retropharyngeal abscess that internal approach was made with Trendelenburg's position under the general anesthesia and then irrigation was done with saline solution daily until healing up of the local wound.