Complex Odontogenic Infection (Oral & Maxillofacial Surgery - Dentistry)
Spread of Odontogenic Infection
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Transcript of Spread of Odontogenic Infection
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8/13/2019 Spread of Odontogenic Infection
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8/13/2019 Spread of Odontogenic Infection
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Handout of Part II lecture - Prof J Weerasingh
Sub Mandibular space
mylohyoid muscle separates the submandibular space from sublingual
mylohyoid muscle also determines the direction of spread of dental infections
apices of the second and third molars below the mylohyoid line and the apex of the first molar above
When penetrates lingual plate
1st molar infection to sublingual2nd,3rd molar infection to submandibular space
Infection further spread to Lateral pharyngeal space
Ludwigs Angina
Ludwig angina is characterized by hard boardlike swelling
from a rapidly spreading cellulitis of the
Bilateral sublingual and submandibular spaces
with elevation and edema of the tongue, saliva drooling,
and airway obstruction.
Submassteric space
contains the pterygoid and masseter muscles insertion of the temporalis muscle
It communicates freely with the temporal space superiorly
and trismus is the most pronounced clinical feature
Lateral (para) pharyngeal space
occupies a critical area in the neck,
communicates with all other fascial spaces
as an inverted cone with its base at the base of skull and apex at the hyoid bone.
divided into anterior and posterior compartments by the styloid process.
Retro pharyngeal & Prevertebral Spaces
bordered anteriorly by the constrictor muscles and posteriorly by the alar layer of the deep cervical fasciInfections of this space can extend down to the superior mediastinum
If the infection perforates the alar layer posteriorly, it enters the danger space, which extends down th
entire mediastinum to the level of the diaphragm. Further extension posteriorly enters the prevertebral spacwhich extends down to the coccyx.
Principles of Management
Removal of the focus if infection
Incision and drainage
Antibiotic therapy
Submasseteric space- through-&-through drainage
Ludwigs Angina
emergency admission
IV antibioticsAirway management
Multiple incisions to relive pressure build-up in the neck