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ENT · Neck: danger space and mediastinitis
Sample itemA diabetic patient with a retropharyngeal infection develops chest pain, fever and widened mediastinum on chest radiograph. Which fascial space connects the neck to the posterior mediastinum?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Danger space between the alar and prevertebral fasciae
The danger space lies between the alar and prevertebral layers of deep cervical fascia and extends from the skull base to the diaphragm, giving direct spread of infection into the posterior mediastinum. The retropharyngeal space ends at about T1 to T2. Descending necrotising mediastinitis is life-threatening.
Option by option
A. Carotid sheath only
The carotid sheath also passes to the chest but is not the classic route from retropharyngeal infection.
B. Masticator space
The masticator space is in the face.
C. Danger space between the alar and prevertebral fasciae (correct)
Correct. This space runs from the skull base to the diaphragm.
D. Pretracheal space
The pretracheal space leads to the anterior mediastinum.
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.
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