0:01

So this was a patient that was involved in some

0:03

kind of trauma and we weren't really quite sure

0:05

what the exact trauma was, but it's probably pretty

0:08

substantial as you'll see, because when we look at

0:11

the pharynx and the inferior pharyngeal wall, right

0:14

at the level of the glossotonsillar sulcus, we can

0:17

see that there's a lot of edema and soft tissue

0:20

swelling involving the lateral pharyngeal wall.

0:23

If we look at the surrounding soft tissues, we can

0:26

see a lot of reticulation of the subcutaneous fat.

0:29

We can see thickening of the platysma muscle.

0:31

We can see the fat surrounding the normal

0:33

masseter muscle completely obliterated.

0:35

Again, all due to reticulation.

0:37

When we look a little bit lower, we can

0:39

see there's a lot of edema here involving

0:41

the free margin of the epiglottis.

0:43

This is actually one vallecula here.

0:45

And this is the second vallecula, and that's all edema.

0:49

When we look at the lateral pharyngeal wall,

0:51

again, we can see there's all edema and

0:53

there's obviously reticulation involving

0:55

the subcutaneous fat and the platysma muscle.

0:58

Now, the point that I wanna make about

0:59

this case is that we know that this

1:01

patient has some type of severe trauma.

1:04

So this is a combination of probable

1:05

hemorrhage, probable edema, so on and so forth.

1:09

But on the other hand.

1:10

This could easily be a severe

1:12

inflammatory process as well too.

1:14

So if someone told me this patient was

1:16

septic, this could easily be early stages

1:19

of necrotizing fasciitis as well too.

1:21

So the imaging findings alone are nonspecific.

1:25

So in situations like this, we have to know

1:27

a little bit more history to determine such

1:30

as if this thickening of the platysma muscle

1:32

and the reticulation of the subcutaneous fat is

1:35

due to trauma or whether it's due to infection.

1:38

And finally, I just wanna point out this diffuse

1:40

thickening involving the lateral pharyngeal wall,

1:43

again, which correlates with the diffuse traumatic

1:46

abnormality that's illustrated in this specific case. s