The retropharyngeal space is sometimes considered a third medial compartment within the parapharyngeal space because these two spaces communicate laterally
This space lies between the visceral division of the middle layer of the deep cervical fascia around the pharyngeal constrictors and the alar division of the deep layer of deep cervical fascia posteriorly
It extends from the skull base to the tracheal bifurcation around T2 where the visceral and alar divisions fuse
Contents: retropharyngeal lymphatics
Anatomic Communication
Entry
Traumatic/Foreign Body Perforation of Posterior Pharyngeal Wall: common in adult cases
Traumatic/Foreign Body Perforation of Esophagus: common in adult cases
Extension from Parapharyngeal Space Abscess (resulting from infections in nose, adenoids, nasopharynx, and sinuses): respiratory tract infections account for >60% of retropharyngeal abscesses in children
Retropharyngeal lymph nodes tend to regress by about age 5 years, making infection in this space much more common in children than adults
Exit
Extension into paravertebral space
Clinical Manifestations
Anterior Displacement of One/Both Sides of Posterior Pharyngeal Wall: due to involvement of lymph nodes, which are distributed lateral to the midline fascial raphe
