牙源性深部面部感染：CT对间隙受累途径的评估
Deep facial infections of odontogenic origin: CT assessment of pathways of space involvement.
作者信息
Yonetsu K, Izumi M, Nakamura T
机构信息
Department of Radiology and Cancer Biology, Nagasaki University School of Dentistry, Sakamoto, Japan.
出版信息
AJNR Am J Neuroradiol. 1998 Jan;19(1):123-8.
PURPOSE
We investigated the pathways of spread of odontogenic infection in the facial and neck spaces.
METHODS
CT scans of 45 patients with extensive spread of odontogenic infection into the facial and neck spaces were analyzed to document pathways of spread.
RESULTS
Odontogenic infections arising in the mandible first spread upward, into the masseter and/or medial pterygoid muscles in the masticator space, and downward, into the sublingual and/or submandibular spaces, and then spread into the spaces or muscles adjacent to one or more of these locations. Infections from the masseter muscle spread into the parotid space to involve the temporalis and lateral pterygoid muscles. Infections from the medial pterygoid muscle spread into the parapharyngeal space to involve the lateral pterygoid muscle. Infections in the maxilla did not spread downward; instead, they tended to spread upward and superficially into the temporal and/or masseter spaces and deeply involve the lateral and/or medial pterygoid muscles in the medial masticator space.
CONCLUSION
CT may be useful to depict the extent of infection and to plan treatment of extensive odontogenic infection, which can be life threatening when therapy is ineffective.
目的
我们研究了牙源性感染在面部和颈部间隙的扩散途径。
方法
对45例牙源性感染广泛扩散至面部和颈部间隙的患者进行CT扫描分析，以记录扩散途径。
结果
下颌骨发生的牙源性感染首先向上扩散至咀嚼肌间隙的咬肌和/或翼内肌，向下扩散至舌下和/或下颌下间隙，然后扩散至与这些部位中一个或多个相邻的间隙或肌肉。咬肌的感染扩散至腮腺间隙，累及颞肌和翼外肌。翼内肌的感染扩散至咽旁间隙，累及翼外肌。上颌骨的感染不会向下扩散；相反，它们倾向于向上和浅表扩散至颞部和/或咬肌间隙，并深入累及咀嚼肌间隙内侧的翼外肌和/或翼内肌。
结论
CT对于描绘感染范围和规划广泛牙源性感染的治疗可能有用，当治疗无效时，这种感染可能危及生命。
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