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一例罕见病例报告:牙源性感染经面部间隙从下颌骨至眼眶的异常途径,导致失明

An unusual route of odontogenic infection from the mandible to the orbit through the facial spaces, resulting in blindness: a rare case report.

作者信息

Nashawi Faez Ebrahim, Alkheder Ahmad, Shasho Hamza Omar, Abdullah Lava, Mohsen Adham Bader Aldeen

机构信息

Department of Otorhinolaryngology, Faculty of Medicine, Damascus University, Al Mouwasat University Hospital, Damascus, Syria.

Department of Obstetrics and Gynecology, Police Hospital, Damascus, Syria.

出版信息

J Surg Case Rep. 2023 Aug 9;2023(8):rjad457. doi: 10.1093/jscr/rjad457. eCollection 2023 Aug.

Abstract

Orbital infection is a rare complication of odontogenic infections, mostly originating from maxillary teeth. In our case, we present one of the unusual routes by which an odontogenic infection of a lower molar tooth has spread into the orbit. A 67-year-old uncontrolled diabetic patient was referred to our hospital with a complaint of a swollen right masseteric region and orbital infection following a dental procedure on the right mandibular third molar. Computed tomography scan and magnetic resonance imaging showed multiple abscesses localized in the masseteric and infratemporal spaces, extending into the orbital cavity through bony erosion in the lateral orbital with no sinus involvement. Improper treatment and poorly controlled diabetes resulted in the extensive spread of the infection. Clinical and radiological reevaluation has played a major role in the management of our case by elucidating the route of infection and localizing abscess foci accurately.

摘要

眶部感染是牙源性感染的一种罕见并发症,大多源于上颌牙齿。在我们的病例中,我们展示了下颌磨牙的牙源性感染扩散至眼眶的一种不寻常途径。一名67岁的糖尿病控制不佳患者因右侧下颌第三磨牙进行牙科手术后出现右侧咬肌区肿胀及眶部感染而被转诊至我院。计算机断层扫描和磁共振成像显示,多个脓肿位于咬肌间隙和颞下间隙,通过眶外侧骨质侵蚀延伸至眶腔,未累及鼻窦。治疗不当及糖尿病控制不佳导致感染广泛扩散。临床和影像学重新评估通过明确感染途径并准确确定脓肿病灶,在我们病例的管理中发挥了主要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64d3/10411988/0db635b6fad3/rjad457f1.jpg

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