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CRANIOFACIAL & SKULL BASE
SURGERY
DENVER, COLORADO
K. K. CHOWDHURY MD, MBA, FRCSC
CHOWDHURY MD, MBA, FRCSC
Complications of Odontogenic and
Head & Neck Infections
K. CHOWDHURY MD, MBA, FRCSC
Center for Craniofacial & Skull Base DisordersDenver, Colorado
Complications of Odontogenic and
Head & Neck Infections
Complications Arise From:
❖ Odontogenic infections
❖ Pharyngeal infections
❖ Sinus infections
❖ Orbital Infections
❖ Temporal Bone and Ear infections
Complications of Odontogenic and
Head & Neck Infections
Complications of Odontogenic and
Head & Neck Infections
Complications of Odontogenic and
Head & Neck Infections
How Does Infection Spread?
1) Local or Direct extension
• Adjacent SPACES…………………to Deep Neck Spaces
• Osteitis…………………………….to OSTEOMYELITIS
Complications of Odontogenic and
Head & Neck Infections
How Does Infection Spread?
1) Local or Direct extension
Complications of Odontogenic and
Head & Neck Infections
How Does Infection Spread?
1) Local or Direct extension
• OSTEOMYELITIS
Complications of Odontogenic and
Head & Neck Infections
How Does Infection Spread?
2) LYMPHATIC
• Lymphadenopathy - common
• Suppurative Lymphadenitis…….communicate with
Deep Neck Spaces!!
Complications of Odontogenic and
Head & Neck Infections
How Does Infection Spread?
2) LYMPHATIC
Complications of Odontogenic and
Head & Neck Infections
How Does Infection Spread?
3) VENOUS or Septic Thrombo-phlebitis
• Direct or indirect…….example: Jugular vein thrombosis
• Septicemia
• Midface and Maxilla:
--Veins are valve less!!
--Drain intracranially
(via ophthalmic and pterygoid venous systems!!)
Complications of Odontogenic and
Head & Neck Infections
How Does Infection Spread?
3) VENOUS or Septic Thrombo-phlebitis
Complications of Odontogenic and
Head & Neck Infections
DEEP NECK SPACE ANATOMY & INFECTIONS
Complications of Odontogenic and
Head & Neck Infections
DEEP NECK SPACE ANATOMY & INFECTIONS
Complications of Odontogenic and
Head & Neck Infections
DEEP NECK SPACE ANATOMY & INFECTIONS
Complications of Odontogenic and
Head & Neck Infections
DEEP NECK SPACE ANATOMY & INFECTIONS
Complications of Odontogenic and
Head & Neck Infections
DEEP NECK SPACE ANATOMY & INFECTIONS
Complications of Odontogenic and
Head & Neck Infections
DEEP NECK SPACE ANATOMY & INFECTIONS
Complications of Odontogenic and
Head & Neck Infections
DEEP NECK SPACE ANATOMY & INFECTIONS
Complications of Odontogenic and
Head & Neck Infections
DEEP NECK SPACES
Complications of Odontogenic and
Head & Neck Infections
DEEP NECK SPACES
Complications of Odontogenic and
Head & Neck Infections
DEEP NECK SPACES
Complications of Odontogenic and
Head & Neck Infections
DEEP NECK SPACES
Complications of Odontogenic and
Head & Neck Infections
DEEP NECK SPACES
Complications of Odontogenic and
Head & Neck Infections
DEEP NECK SPACES
Complications of Odontogenic and
Head & Neck Infections
DEEP NECK SPACES
Complications of Odontogenic and
Head & Neck Infections
DEEP NECK SPACES
Complications of Odontogenic and
Head & Neck Infections
DEEP NECK SPACES
Complications of Odontogenic and
Head & Neck Infections
DEEP NECK SPACES
Complications of Odontogenic and
Head & Neck Infections
Complications of Odontogenic and
Head & Neck Infections
DEEP NECK SPACES
Complications of Odontogenic and
Head & Neck Infections
Complications of Odontogenic and
Head & Neck Infections
DEEP NECK SPACES
Complications of Odontogenic and
Head & Neck Infections
DEEP NECK SPACES
Complications of Odontogenic and
Head & Neck Infections
DEEP NECK SPACES
Complications of Odontogenic and
Head & Neck Infections
DEEP NECK SPACE INFECTIONS
Complications of Odontogenic and
Head & Neck Infections
DEEP NECK SPACE INFECTIONS
Complications of Odontogenic and
Head & Neck Infections
Clinical Presentation
Complications of Odontogenic and
Head & Neck Infections
Clinical Presentation
Complications of Odontogenic and
Head & Neck Infections
IMAGING
Complications of Odontogenic and
Head & Neck Infections
IMAGING
Complications of Odontogenic and
Head & Neck Infections
IMAGING
Complications of Odontogenic and
Head & Neck Infections
MANAGEMENT
❖ Prevention of Complications from Odontogenic Infections is the best and gold standard
❖ Early Odontogenic infections should be treated promptly with appropriate antibiotics +/- drainage as needed
❖ Uncontrolled odontogenic infections resulting in complications …………..significant morbidity and mortality(pre-antibiotic era)
❖ Complications from Head & Neck/Odontogenic infections are less common in post antibiotic era…..do not under estimate morbidity!
Complications of Odontogenic and
Head & Neck Infections
MANAGEMENT
❖ When Complications occur: prompt recognition, early diagnosis, and aggressive treatment………..minimize morbidity and mortality !❖ These Patients are toxic and very ill.
Complications of Odontogenic and
Head & Neck Infections
MANAGEMENT
Complications of Odontogenic and
Head & Neck Infections
MANAGEMENT
Complications of Odontogenic and
Head & Neck Infections
MANAGEMENT
Complications of Odontogenic and
Head & Neck Infections
MANAGEMENT
Complications of Odontogenic and
Head & Neck Infections
MANAGEMENT
Complications of Odontogenic and
Head & Neck Infections
MANAGEMENT
Complications of Odontogenic and
Head & Neck Infections
MANAGEMENT
Complications of Odontogenic and
Head & Neck Infections
MANAGEMENT PROBLEMS
Complications of Odontogenic and
Head & Neck Infections
MANAGEMENT PROBLEMS
Complications of Odontogenic and
Head & Neck Infections
MANAGEMENT PROBLEMS
Complications of Odontogenic and
Head & Neck Infections
MANAGEMENT PROBLEMS
Complications of Odontogenic and
Head & Neck Infections
MANAGEMENT - LUDWIG’S ANGINA (Submandibular & Submental)
Complications of Odontogenic and
Head & Neck Infections
MANAGEMENT - LUDWIG’S ANGINA (Submandibular & Submental)
❖ > 50 % mortality (airway & sepsis) 1900-1935!!
Complications of Odontogenic and
Head & Neck Infections
MANAGEMENT - LUDWIG’S ANGINA (Submandibular & Submental)
Complications of Odontogenic and
Head & Neck Infections
MANAGEMENT - LUDWIG’S ANGINA (Submandibular & Submental)
Complications of Odontogenic and
Head & Neck Infections
INTRACRANIAL COMPLICATIONS
❖ Meningitis
❖ Osteomyelitis
❖ Subdural Empyema
❖ Brain Abscess
❖ Cavernous Sinus Thrombosis
Complications of Odontogenic and
Head & Neck Infections
INTRACRANIAL COMPLICATIONS
Complications of Odontogenic and
Head & Neck Infections
INTRACRANIAL COMPLICATIONS
Cavernous Sinus Thrombosis
Complications of Odontogenic and
Head & Neck Infections
INTRACRANIAL COMPLICATIONS
Cavernous Sinus Thrombosis
Complications of Odontogenic and
Head & Neck Infections
INTRACRANIAL COMPLICATIONS
Cavernous Sinus Thrombosis
Complications of Odontogenic and
Head & Neck Infections
INTRACRANIAL COMPLICATIONS
Complications of Odontogenic and
Head & Neck Infections
Craniofacial & Skull Base Surgery
Craniofacial & Skull Base Surgery
Complications of Odontogenic and
Head & Neck Infections
Complications of Odontogenic and
Head & Neck Infections
MANAGEMENT