Masticator space infections: Difference between revisions
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*Consists of 4 contiguous potential spaces bounded by the muscles of mastication: | *Consists of 4 contiguous potential spaces bounded by the muscles of mastication: | ||
**Masseteric, superficial temporal, deep temporal, pterygomandibular | **Masseteric, superficial temporal, deep temporal, pterygomandibular | ||
*Bacteria gain entry to the space from<ref name="Ko">Ko I-C, Yoon K-H, Park K-S, et al. An unusual abscess formation in the masticator space after acupressure massage: a case report. Journal of the Korean Association of Oral and Maxillofacial Surgeons. 2015;41(1):52-56. doi:10.5125/jkaoms.2015.41.1.52.</ref>: | *Bacteria gain entry to the space from<ref name="Ko">Ko I-C, Yoon K-H, Park K-S, et al. An unusual [[abscess]] formation in the masticator space after acupressure massage: a case report. Journal of the Korean Association of Oral and Maxillofacial Surgeons. 2015;41(1):52-56. doi:10.5125/jkaoms.2015.41.1.52.</ref>: | ||
**Odontogenic (tooth extractions, periodontitis, pericoronitis, dental caries, pulpitis, etc) - most common source | **Odontogenic (tooth extractions, periodontitis, pericoronitis, [[dental caries]], [[pulpitis]], etc) - most common source | ||
**Trauma (e.g. to the TMJ) | **[[facial trauma|Trauma]] (e.g. to the TMJ) | ||
**Surgery | **Surgery | ||
**Injections (e.g. inferior alveolar block) | **Injections (e.g. inferior alveolar block) | ||
| Line 10: | Line 10: | ||
==Clinical Features== | ==Clinical Features== | ||
*Initial symptoms are similar to TMJ disease | *Initial symptoms are similar to [[TMJ]] disease | ||
*Trismus | *Trismus | ||
*Tenderness to muscles of mastication | *Tenderness to muscles of mastication | ||
*Facial swelling and erythema | *Facial swelling and erythema | ||
*Fever, malaise, dysphagia | *[[Fever]], malaise, [[dysphagia]] | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Facial swelling DDX}} | {{Facial swelling DDX}} | ||
== | ==Evaluation== | ||
*CT of facial bones with IV contrast | *CT of facial bones with IV contrast | ||
Latest revision as of 21:12, 30 September 2019
Background
- Consists of 4 contiguous potential spaces bounded by the muscles of mastication:
- Masseteric, superficial temporal, deep temporal, pterygomandibular
- Bacteria gain entry to the space from[1]:
- Odontogenic (tooth extractions, periodontitis, pericoronitis, dental caries, pulpitis, etc) - most common source
- Trauma (e.g. to the TMJ)
- Surgery
- Injections (e.g. inferior alveolar block)
- Spaces communicate with the tissue planes that extend down the neck to the mediastinum
Clinical Features
- Initial symptoms are similar to TMJ disease
- Trismus
- Tenderness to muscles of mastication
- Facial swelling and erythema
- Fever, malaise, dysphagia
Differential Diagnosis
Facial Swelling
- Buccal space infections
- Dental problems
- Canine space infection
- Facial cellulitis
- Herpes zoster
- Masticator space infections
- Maxillofacial trauma
- Neoplasm
- Parapharyngeal space infection
- Salivary gland diagnoses
- Parotitis
- Ranula
- Sialoadenitis
- Sialolithiasis
- Superior vena cava syndrome
Evaluation
- CT of facial bones with IV contrast
Management
- Clindamycin IV
- Consult ENT for surgical drainage of abscess
Disposition
- Admit