How do we approach the retropharyngeal abscess with mediastinal extension?

Retropharyngeal abscess is an uncommon but may develop rare complications, but potentially serious, as the invasion of adjacent structures, sepsis, mediastinitis or mediastinal extension thereof, obstruction of the airway, thrombosis of the internal jugular vein aneurysm carotid artery, requiring surgical treatment in many cases. It is presented as an example of handling, the case of a 4-year extension mediastinal abscess initially treated conservatively, but finally treated by transoral drainage of the abscess and surgical approach to the extension to the mediastinum. As remarkable complication associated with this condition developed Grisel syndrome. There is considerable controversy regarding the treatment of this disease, antibiotic treatment of conservative surgical option. For all this seems so necessary to formalize its approach more formal and present our proposal multidisciplinary approach and surgical treatment in cases of poor outcome, airway obstruction or evidence of mature abscess.