Choi Moon-Gi
Department of Oral and Maxillofacial Surgery, College of Dentistry, Wonkwang University, Iksan, Korea.
Wonkwang Dental Research Institute, Wonkwang University, Iksan, Korea.
J Korean Assoc Oral Maxillofac Surg. 2017 Jun;43(3):197-203. doi: 10.5125/jkaoms.2017.43.3.197. Epub 2017 Jun 28.
Once a submasseteric space infection is diagnosed, the key to resolving the infection is via surgical intervention to evacuate the pus. Although it is possible and occasionally practical to drain the submasseteric space via an intraoral approach, an extraoral approach may sometimes be required. Surgeons have encountered complications such as facial nerve damage during extraoral incision and drainage procedures, and they have felt that extraoral dissection was very difficult. As such, an easier and simpler technique is needed. Our department recently modified various drainage techniques for submasseteric space abscesses. Damage to the marginal branch of the facial nerve did not occur, and this technique was very simple and rapid, such that a novice physician could perform this procedure. This modified technique was possible with trismus and under local anesthesia. After intraorally checking the position of the drain, the intraoral wound is closed with an absorbable suture and the drain is fixed to the extraoral skin. When a masseteric space infection is diagnosed, multiple space involvement is ruled out, and dependent drainage is required, this modified drainage technique can be useful.
一旦诊断出咬肌下间隙感染,解决感染的关键在于通过手术干预排出脓液。虽然通过口内途径引流咬肌下间隙是可行的,偶尔也是实用的,但有时可能需要口外途径。外科医生在口外切开引流手术中遇到过诸如面神经损伤等并发症,并且他们觉得口外解剖非常困难。因此,需要一种更简便的技术。我们科室最近对咬肌下间隙脓肿的各种引流技术进行了改良。未发生面神经边缘支损伤,且该技术非常简单快捷,新手医生也能进行此操作。这种改良技术在牙关紧闭和局部麻醉情况下也可行。在口内检查引流管位置后,用可吸收缝线关闭口内伤口,并将引流管固定于口外皮肤。当诊断出咬肌间隙感染、排除多间隙受累且需要重力引流时,这种改良引流技术可能会有用。