Spread of Infection Flashcards
Where can a maxillary abscess spread to
- buccal space (if above buccinator)
- draining sinus (if below buccinator)
- into maxillary sinus (unusual)
- palatal route (painful)
Where can a mandibular abscess spread to?
- lingually to give sublingual abscess (above mylohyoid)
- lingually into submandibular space (below mylohyoid)
- buccally below buccinator
- buccally above buccinator
What determines where an infection spreads on the lower jaw
- The mylohyoid muscle attachement
i.e. above muscle = lingually into sublingual space; below muscle = submandibular space - Tooth anatomy
- 33 = sublingual, 37 = submandibular
Also, muscle is open at the back so infection in sublingual space could spread into submandibular space and vice versa
What are the different (masticatory) posterior potential spaces infection can spread to
- superficial temporal space
- deep temporal space
- infratemporal space
- masseteric space
- pterygomandibular space
what happens to the muscles of mastication when infection gets into the spaces around the mandible
they spasm (trismus)
after spreading to masticatory spaces, where can infection then spread
- lateral pharygeal space (first)
- retropharyngeal space
- prevertable space
then even further…
after infection goes through the retropharyngeal and prevertable spaces, where can it then go
- up into the brain
- down into the mediastinum
what infection could result if infection reaches the brain
cavernous sinus thrombosis
where do infections tend to spread from the upper anterior teeth
- lip
- nasiolabial region
- lower eyelid
Where do infections tend to spread from the upper lateral incisor
palate
because the apex of its root is more palatally placed
where do infections tend to spread from upper premolars and molars
- cheek
- infra-temporal region
- maxillary antrum
- palate
What is the diagnosis for this and where is this infection most likely spreading
Intraoral (labial) abscess
Draining into mouth so spreading below buccinator
Where is this patients infection spreading
Buccal but above muscle insertions
- swellings in cheek, infraorbital region and buccal
- partial closure of eye
how would you describe this spread of infection
mainly infra orbital, not buccal yet nb nasiolabial fold gone (nose deformed)
how would you describe this spread of infection
mainly buccal spread, more mild
how would you describe this spread of infection
buccal and infraorbital spread (nasio labial fold still here in this case)
nb unusual for upper infections to spread back but can happen
Where do lower anterior teeth infections spread
mental and submental space
often stay there but can spread to sublingual and submandibular spaces
How would you describe this spread of infection
submental spread
- tend to be self liimiting and eventually burst and drain through skin
pure submandibular spread?
What is this and how did it happen
Submental sinus tract to skin
- has burst and formed a chronic sinus which is draining EO
- once infection removed will have to do plastic surgery to get rid of scar
What would you call this spread of infection and what would the clinical appearance be
Submandibular spread
- won’t be able to feel lower border of the mandible
- could spread to other side or more worryingly backwards into submassateric space, pterygomandibular space, lateral pterygoid space
- check systemic symptoms
- need to incise and drain as well as extract tooth
What spread of infection is this
buccal and submandibular spread
- now cannot feel lower border of mandible
- check systemic symptoms
What view of a radiograph is this
lateral oblique radiograph
What is the arrow pointing at
submandibular sinus tract to skin
what is this
extra-oral sinus
describe this swelling
buccal space spread
What radiographic view is this
lateral oblique
What type of infection spread is this
submandibular space spread
quite low down in this case
What are the different scores in NEWS2
0 - normal
1
2
3 - most unwell
