Retropharyngeal nodes

At a glance

English

Retropharyngeal nodes

Latin (TA2)

Nodi retropharyngei

System

Lymphatic

Region

Head

Side

Paired, left and right

About the retropharyngeal nodes

The retropharyngeal nodes lie in the retropharyngeal space, the narrow plane of loose tissue between the back wall of the pharynx and the prevertebral fascia. They sit behind the upper pharynx at the level of the atlas, embedded in the buccopharyngeal fascia that covers the outer surface of the pharyngeal muscles. There are usually one to three on each side. The longus capitis muscle lies between them and the front of the anterior arch of the atlas.

They are often described in two groups: lateral nodes near the internal carotid artery, of which the uppermost is known as the node of Rouviere, and smaller medial nodes nearer the midline. Being deep and high, they cannot be felt from the neck, and they are usually seen only on CT or MRI.

These nodes receive lymph from the nasal cavities and paranasal sinuses, the nasopharynx and the auditory tubes, and also from the middle ear and the upper part of the oropharynx. Their outflow passes down and outward to the upper deep cervical nodes along the internal jugular vein.

In young children these nodes are relatively large, and an infection of the nose or throat can cause one to suppurate and form a retropharyngeal abscess, which can narrow the airway and give fever, neck stiffness and difficulty swallowing. The nodes shrink and often disappear in early childhood, which is why such abscesses become uncommon after about five years of age. In adults the lateral retropharyngeal node is a frequent early site of spread from nasopharyngeal cancer, and its state is checked when the disease is staged.

Course and drainage

Begins at

Afferent vessels from the nasal cavities and paranasal sinuses, the nasopharynx, the auditory tubes and middle ear, and the upper oropharynx.

Drains into

Efferent vessels drain to the upper deep cervical nodes along the internal jugular vein.

Drains

Filters lymph from the nose, nasopharynx and auditory tubes. In small children infection can turn a node into a retropharyngeal abscess that threatens the airway; in adults the lateral node is an early site of spread from nasopharyngeal cancer.