Abstract
The authors experienced a case of retropharyngeal abscess in which a syncope was caused at the abscess-punction.
Generally text books say that the death or the syncope at the punction of retropharyngeal abscess is due to the vagus paralysis which arises from the sudden decrease of abscess-pressure.
For the past fifty seven years, 120 cases of retropharyngeal abscess have been treated as inpatients in the authors' clinic. Their operation records were discussed in detail. Then it was found that the cause of their syncope was not vagus paralysis but the obstruction at the hypopharynx in the headdown position by the following points.
1) The syncope had occured before sucking the pus.(So vagus pressure was unchanged.)
2) The syncope came whenever the patients were assumed the headdown position.
Roentgenologically it was proved that the hypopharynx space was narrower in the headdown position than in the dorsal one.
Therefore the patients should not be taken Rose's position but Trendelenburg-like one at the operation of retropharyngeal abscess.
