Kim H J, Park E D, Kim J H, Hwang E G, Chung S H
Department of Diagnostic Radiology, Gyeongsang National University Hospital, Chilam-dong, Chinju, Korea.
J Comput Assist Tomogr. 1997 Mar-Apr;21(2):202-8. doi: 10.1097/00004728-199703000-00006.
The purpose of this study was to evaluate deep neck space infection (DNSI) with particular attention to the differences in the spaces involved and in complications between odontogenic and nonodontogenic groups with CT.
Forty-four patients (21 odontogenic and 23 nonodontogenic) were included in this study. Among odontogenic DNSI cases, 15 had dental infection in the second or third mandibular molar. We compared the CT features between odontogenic and nonodontogenic DNSI cases, with special emphasis on the differences in the spaces involved and in the rate and type of complications.
In all patients, CT clearly differentiated abscess from cellulitis. The most common spaces involved in 21 patients with odontogenic DNSI were the parapharyngeal (n = 18), the submandibular (n = 18), the anterior visceral (n = 13), the masticator (n = 9), and the sublingual (n = 7) spaces. In contrast, in 23 patients with nonodontogenic DNSI, the anterior visceral space (n = 14) was most frequently involved. The parapharyngeal, submandibular, and masticator spaces were statistically more frequently involved in odontogenic than in nonodontogenic DNSI (p < 0.05). Twenty-two patients had one or more complications shown by CT, of which airway compromise was more frequent and severe in odontogenic than in nonodontogenic DNSI.
We conclude that the parapharyngeal, submandibular, and masticator spaces are more significantly vulnerable in odontogenic DNSI than in nonodontogenic DNSI. The predilection for certain spaces of the neck in odontogenic DNSI seems to originate from the intimate relationship of the mandibular molars to the adjacent deep neck spaces.
本研究旨在评估颈部深部间隙感染（DNSI），特别关注牙源性和非牙源性组在受累间隙及并发症方面的差异，并进行CT检查。
本研究纳入44例患者（21例牙源性和23例非牙源性）。在牙源性DNSI病例中，15例下颌第二或第三磨牙存在牙齿感染。我们比较了牙源性和非牙源性DNSI病例的CT特征，特别强调受累间隙的差异以及并发症的发生率和类型。
在所有患者中，CT能够清晰地区分脓肿和蜂窝织炎。21例牙源性DNSI患者中最常受累的间隙为咽旁间隙（n = 18）、下颌下间隙（n = 18）、内脏前间隙（n = 13）、咀嚼肌间隙（n = 9）和舌下间隙（n = 7）。相比之下，23例非牙源性DNSI患者中，最常受累的是内脏前间隙（n = 14）。与非牙源性DNSI相比，牙源性DNSI中咽旁间隙、下颌下间隙和咀嚼肌间隙受累的统计学频率更高（p < 0.05）。22例患者出现了CT显示的一种或多种并发症，其中气道受损在牙源性DNSI中比在非牙源性DNSI中更频繁且更严重。
我们得出结论，与非牙源性DNSI相比，牙源性DNSI中咽旁间隙、下颌下间隙和咀嚼肌间隙更易受累。牙源性DNSI对颈部某些间隙的偏好似乎源于下颌磨牙与相邻颈部深部间隙的密切关系。
