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Masticator space infections
From WikEM
Contents
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
- Superior vena cava syndrome
- Buccal space infections
- Dental problems
- Masticator space infections
- Parapharyngeal space infection
- Neoplasm
- Maxillofacial trauma
- Facial cellulitis
- Canine space infection
- Salivary gland diagnoses
Evaluation
- CT of facial bones with IV contrast
Management
- Clindamycin IV
- Consult ENT for surgical drainage of abscess
Disposition
- Admit
