Farrier J N, Kittur M A, Sugar A W
Department of Oral & Maxillofacial Surgery, Morriston Hospital, Swansea, UK.
Br Dent J. 2007 May 26;202(10):607-9. doi: 10.1038/bdj.2007.425.
Inadequate treatment or neglect of odontogenic infections can have serious consequences. The potential for spreading through fascial planes and intracranially can cause compromise of the airway and cavernous sinus thrombosis respectively. On rare occasions this can lead to a rapidly progressing necrotising fasciitis, with destruction of soft tissue, making reconstruction difficult. Antibiotic administration without removal of the cause is inadequate and can complicate subsequent management. We report the presentation and successful management of a 13-year-old boy, who developed necrotising fasciitis in the submandibular region as a result of inadequate initial treatment of a carious, lower molar resulting in significant skin and soft tissue loss.
对牙源性感染治疗不当或疏于治疗会产生严重后果。感染通过筋膜间隙扩散以及向颅内蔓延的可能性,分别会导致气道受压和海绵窦血栓形成。在极少数情况下,这会引发迅速进展的坏死性筋膜炎,造成软组织破坏,给重建带来困难。在未消除病因的情况下使用抗生素是不够的,还会使后续治疗复杂化。我们报告了一名13岁男孩的病例及成功治疗过程,该男孩因下颌磨牙龋坏初始治疗不当,导致下颌下区发生坏死性筋膜炎,造成了大面积皮肤和软组织缺损。