Deep neck infections: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Deep neck infections

Sample item

A 3-year-old has fever, refusal to eat, neck stiffness and drooling. A lateral soft-tissue neck radiograph shows widening of the prevertebral space. After starting intravenous antibiotics, how should an established abscess be drained?

ATransoral incision at the most dependent part, with the head downBSublingual incision through the floor of the mouthCNeedle aspiration only, with no further surgeryDExternal incision along the posterior border of sternomastoid

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Transoral incision at the most dependent part, with the head down

Retropharyngeal abscess is typically seen in children under five because of suppuration of the retropharyngeal lymph nodes, and the lateral view shows a widened prevertebral space. Most abscesses are drained through an intra-oral incision with the child in the head-low position to avoid aspiration, with an airway ready.

Option by option

A. Transoral incision at the most dependent part, with the head down (correct)
Correct. A transoral approach drains a bulge in the posterior pharyngeal wall.
B. Sublingual incision through the floor of the mouth
A floor-of-mouth incision does not reach a pharyngeal wall abscess.
C. Needle aspiration only, with no further surgery
Aspiration alone leaves an abscess that is usually too loculated to resolve.
D. External incision along the posterior border of sternomastoid
External incisions are used when the abscess has extended into the neck, not as the routine approach for a midline abscess.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this ENT question

What is the answer to this ENT question?

The best answer is A, Transoral incision at the most dependent part, with the head down. Retropharyngeal abscess is typically seen in children under five because of suppuration of the retropharyngeal lymph nodes, and the lateral view shows a widened prevertebral space.

Why is "Sublingual incision through the floor of the mouth" not the answer?

A floor-of-mouth incision does not reach a pharyngeal wall abscess.

Why is "Needle aspiration only, with no further surgery" not the answer?

Aspiration alone leaves an abscess that is usually too loculated to resolve.

Why is "External incision along the posterior border of sternomastoid" not the answer?

External incisions are used when the abscess has extended into the neck, not as the routine approach for a midline abscess.

What concept does this question test?

It tests Deep neck infections in ENT. Most abscesses are drained through an intra-oral incision with the child in the head-low position to avoid aspiration, with an airway ready.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Deep neck infections?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.