Smas fusion zones determine the subfascial and subcutaneous. Spread of oral infections in fascial spaces human head. Analysis of maxillofacial and neck spaces infection in. Pdf pattern of odontogenic fascial space infections among a. Odontogenic infections any closed space that becomes infected, or any situation where an abscess forms, is an indication for surgical intervention, with or without antibiotic therapy principles of management of deep space infections 1. The space coincides with the anatomic region termed the submental triangle, part of the anterior triangle of the neck. Ultrasonography demonstrated 32 76% of 42 involved fascial spaces.
Odontogenic infections of the fascial spaces chapter focuses on the etiology, clinical manifestations, anatomic considerations, and treatment of odontogenic infections. Fortytwo fascial spaces in 16 subjects, clinically diagnosed as odontogenic infections, were included in this prospective study. Main space involvement and severity scoring figure 3, figure 4 anatomic spaces of the head and neck are scored by their severity according to the potential compromise of air way and other vital structures, such as, heart, mediastinum and cns. The knowledge of the anatomy of fascial spaces is essential for the correct diagnosis and treatment of head and neck infections, because both facial and cervical fasciae work as an effective barrier against the spread of infections in this region1, 2. Infections of the oral cavity are most commonly odontogenic in origin and include dentoalveolar, periodontal, and deep fascial space infections. Fascial spaces free download as powerpoint presentation.
Deep neck space infections can spread along the fascial spaces of the head and neck, inducing lifethreatening deep space infection. Dr surbhi pg 1st year dept of omr under the guidance of. Space infections in dentistry pdf edema of the involved soft tissue space. Severity score as a prognostic factor for management of. The submental space is a fascial space of the head and neck sometimes also termed fascial spaces or tissue spaces. Pdf on jan 1, 2016, yousif i eltohami and others published pattern of odontogenic fascial space infections among a sample of sudanese patients find. Fascial spaces also termed fascial tissue spaces or tissue spaces are potential spaces that exist between the fasciae and underlying organs and other tissues.
The knowledge of the anatomy of fascial spaces is essential for the correct diagnosis and treatment of head and neck infections, because both facial and cervical. May 11, 2012 once incision and drainage of fascial space abscess is performed, drain is placed and the wound is dressed which is changed several times over subsequent days and irrigated daily. Efficacy of serum prealbumin as monitoring tools for patients. Deep neck space infections can spread along the fascial spaces of the head and neck, inducing lifethreatening deep space infection associated with a high risk of complications. Deep neck space infection dni is defined as an infection in the potential. In this study, the majority of patients had encountered severe fascial space infections namely submental, bilateral submandibular and sublingual space cellulitis ludwigs angina. Jul 04, 2016 from anterior to posterior, they are 1 the visceral space, 2 the retropharyngeal space, 3 the danger space, and the 4 prevertebral space. Masticator space and parapharyngeal space abscesses directly extend into intracranial lesion through foramen ovale. It is a potential space located between the mylohyoid muscle superiorly, the platysma muscle inferiorly, under the chin in the midline. Common acute hand infections american family physician. This video highlights important fascial spaces and how dental infection can spread through them to mediastinum. Learn vocabulary, terms, and more with flashcards, games, and other study tools. The fascial space involvements were examined with usg. Antimicrobial therapy and surgical management of odontogenic.
Fascial space infection infection from a web space or from an ppt. Anatomy and surgery of oral and maxillofacial thomas r. Exploration of ultrasonography in assessment of fascial. Emerging trends in antibiotic management of deep fascial space. The results were confirmed by mri and microbiologic tests. Fascial spaces dental anatomy common carotid artery. Infections and deep fascial space infections of dental origin. Before the advent of antibiotics, upper respiratory infections were the most common, but now the prevalence of odontogenic infection is on the increase in spite of developments in medicine and improvements in dental care. Infection in the middie pal fascia to the fifth metacarpa1.
Buccal space involvement was always associated with masseter muscle involvement table 2. But there is a need for prospective studies, which would provide reliable and accurate information on the true incidence of this significant post. Infections of the fascial spaces of the head and neck. But if infection increase or failed to subside, further surgical intervention was done and antibiotic regime changed according to culture and sensitivity reports. Incidence of deep fascial space infections following lower. The contents of the neck are enveloped by fascia known. Host factors, location, and circumstances of the infection are important guides to initial treatment. Infratemporal space extension of infection from maxillary molars can pass into this space.
Irrigation with saline and antibiotic solution has been reported to be effective in the elimination or reduction of infection 1. The fascial layers limit and also direct the spread of infection. Anatomical considerations in the diagnosis and management of acute maxillofacial bacterial infections bridgeman 1996 australian dental journal wiley online library. Pdf management of odontogenic fascial space infection in. Jun 01, 2009 based on the present results, usg was a valuable addition in diagnosis of superficial fascial space infections and in demonstrating the stages of infections. The purpose of this study was to determine trends in antibiotic usage to manage severe head and neck infections over a 10year period at a large level i medical. Fascial spaces, lymphatics, and the spread of dental infection. Three different numbering systems are used in dentistry figure 14. The esthetic surgical management of a submandibular. Hence it is important to know how to number the teeth, especially when interpreting radiology reports.
Although the incidence of deep neck space infection dnsi has decreased due to the use of antibiotics, this infection continues. Spread of oral infections in fascial spaces free download as powerpoint presentation. Tooth involvement tooth number of pa percentinvolved tients with in age volved tooth maxillary canine 1 3. Such infections are usually selflimiting, but on rare occasions may result in lifethreatening complications such as mediastinal or intracranial extension, retropharyngeal spread with airway. Different fascial spaces are contained in each of the portions, although the spaces belonging to the portion of the same depth communicate freely with each other. Anatomy of the neck spaces the anatomy of the neck spaces is helpful in understanding the source, direction, and spread of infection table 24.
Odontogenic infections have become one of the major sources of fascial space infections in the head and neck region, which have the potential to spread via the. The esthetic surgical management of a submandibular fascial. Deep neck space infections are unique among infection diseases for their variability and potential for several complications 1. Nasal and paranasal sinus infections chapter discusses the pathophysiology and management of nasal and paranasal sinus infections. Infection may also spread from the pterygomandibular, parotid, or lateral pharyngeal region to the infratemporal space. Most frequent causes of this space infection are the dental abscesses, pericornitis of mandibular molars and post surgical infections. Oct 15, 2014 the aim of this presentation is to show the clinical characteristics of a submandibular fascial space abscess and its esthetic, minimallyinvasive surgical management. Dec 01, 2003 hand infections can result in significant morbidity if not appropriately diagnosed and treated. Twelve patients had severe deep fascial space infections in the head and neck with a direct threat to the airway. Severe submandibular facial space infection table 2. An odontogenic parapharyngeal abscess reaching the base of the skull clara carracha, andreia silva, henrique oliveira, luis nunes da silva, paulo valejo coelho abstract introduction. May 22, 2017 patients are now informed of the low risk of post. Other muscles in the masticator space were less frequently involved in buccal space infection.
Feiiow in orthopedic surgery, university of oklahoma school of. Maxillofacial space infection experience in west china. Deep temporal space by extending superiodeep temporal space by extending superioposteriorly. Sep 01, 2009 these findings suggested that the infection might have involved the masticator space first, and then it extended to the parapharyngeal space. Fascial space infections of the head and neck region, though potentially life threatening, can be. Pattern of odontogenic fascial space infections among a sample of sudanese patients. The primary spaces discussed so far are immediately adjacent to the toothbearing portions of the maxilla and mandible. Infection of the deep facial spaces of the head and neck still represents a major challenge in hospitals. Odontogenic maxillofacial space infections at a tertiary care center. Start studying fascial spaces, lymphatics, and the spread of dental infection. Pdf efficacy of serum crp levels as monitoring tools for.
Oromaxillofacial infections usually occur in the fascial planes and potential spaces of the maxillofacial region due to dental caries, periodontitis. Spread of oral infections in fascial spaces human head and. A retrospective analysis of risk factors of oromaxillofacial infection in. Oral and maxillofacial infection is a daily case in the dental clinic with serenity range from periapical abscess to infection of the fascial space.
Odontogenic fascial space infection in a cambodian public. Odontogenic infections contribute to a significant proportion of maxillofacial. The goal of this chapter is to present the basis for correct diagnosis and management of severe odontogenic infections. The spaces of the superficial portions are adjacent to the oral cavity and constitute the starting point of deep infections from that cavity. If proper treatment is not received for infections of the primary space 1 the infections may extend posterioriy to involve the secondary fascial spaces.
Case report we present two cases of submandibular space abscesses that underwent surgical treatment using an esthetic incision with a throughandthrough suction drainage of the. However, mri was superior to usg in assessment of deep fascial space involvements, such as the parapharyngeal and masticator spaces. Infections of the fascial spaces of the head and neck ento key. The advent of advanced imaging and powerful antimicrobial therapy has allowed more deep neck space infections to be managed with medical therapy alone. Ppt fascialspace download powerpoint presentations. Exploration of ultrasonography in assessment of fascial space. Previous descriptions of anatomic spaces always included the anatomical structures contained within these spaces. Full text modified usage of negative pressure wound therapy for. It is a potential space located between the mylohyoid muscle superiorly, the platysma muscle inferiorly, 1 under the chin in the midline.
A case of brain abscess extended from deep fascial space. Efficacy of serum prealbumin as monitoring tools for. Anand dr archana nagpal dr puneeta vohra dr sanjeev lallar dr mamta malik. Article information, pdf download for deep neck space infections.
Early diagnosis of these deep fascial abscesses and aggressive antimicrobial and surgical treatment with extensive drainage are of utmost importance. Contents introduction definition and classification fascial space infections various fascial space infections in head and neck conclusion references 3. The aim of this presentation is to show the clinical characteristics of a submandibular fascial space abscess and its esthetic, minimallyinvasive surgical management. Fascial spaces in the head and neck are fascialined tissue compartments filled with. The thenar mar space is usually from the middie, ring space iies chief3 y between the palmar. Considerations for the spread of odontogenic infections. Odontogenic fascial space infection in a cambodian public hospital. Fascial spaces and spread of dental infection youtube. Aug 08, 2016 submandibular space infections are common. Fascia is dense connective tissue and neck is draped with layers of fascia with potential spaces between them referred as neck spaces.
The fascial spaces can also be opened during the dissection of a cadaver. The contents of the neck are enveloped by fascia known as cervical fascia. Prevertebral space dental numbering systems fascial space infections are often. The purpose of this study was to suggest a protocol for the management of odontogenic space infections in patients with. Simple manoeuvre to help irrigate the fascial space infections. Understanding the anatomy and the relationships between the fasciae of the head and neck and their spaces is mandatory for comprehending the manner of spread of most infections and some tumors. Deep fascial neck spaces are prevertebral, danger space, retropharyngeal, parapharyngeal, visceral vascular space and pretraqueal spaces.
Neck spaces infection in diabetic and non diabetic patients. Odontogenic infections chapter 3 onur gonul, sertac aktop. Fascial infections derived from maxillary odontogenic origins the spread pattern of maxillary infection differed. Odontogenic fascial space infection in pregnancy fig. It also examines the spread of dental infections from the. Objectives to assess efficacy of serum prealbumin levels as monitoring tools for patients with fascial space infections of odontogenic origin for determining. The patient then complains of pain, particularly with mouth opening, some dysphagia, and. Periapical, peridontal, postsurgical, pericoronal may begin as welldelineated, selflimiting condition with potential to spread and result in a major fascial space infection. Fascial space infections are often of odontogenic origin. A study on deep neck space infections, nirmal kumar j. Such infections are usually well localized in their initial stages but can spread to become severe and poten. However, detailed knowledge of the neck spaces and fascial planes is mandatory in order to predict patterns of spread and the possible effects on surrounding structures. Dental abscess which penetrate the lingual cortical. Severe space infections present a challenging problem to the maxillofacial.
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