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Background and Objectives:Parapharyngeal infections are rare but they cause life-threatening complications such as medi-astinitis, rupture or aneurysm of the internal carotid artery, internal jugular vein thrombophlebitis. So, until now, the recommended treatment of parapharyngeal absces is early open surgical drainage. The purpose of this study is to review the clinical course and outcome of treatment in parapharyngeal abscess according to method of treatment. Materials and Method:A retrospective study was peformed on 34 cases with parapharyngeal abscess in patients admitted for deep neck infection during a 8-year period from June 1994 to January 2003. Al had contrast-enhanced computed tomography (CT) imaging and had confirmation of an abscess in parapharyngeal space. Results:All patients were treated with intravenous antibiotics, 19 cases ( ) were treated with antibiotics only or needle aspiration, 15 cases (surgical group) were treated with intraoral or external drainage. The mean period of hospitalization was 8.2 days in conservative group and 11.6 days in surgical group. There was no complication except the mediastinitis in one case of conservative group. Five patients required tracheotomy because of severe dyspnea. Conclusion:Neck CT scan is useful diagnostic tool to detect and establish treatment plan of parapharyngeal absces. Para-ely with no need for early open surgical drainage. (Korean J Otolaryngol 2003 ;46 :769-74)