SUBMANDIBULAR SPACE INFECTION

-VAISHNAVI KAMESWARIIII BDS

Infection involving the submandibular fascial space

CLASSIFICATION

• Primary –Directly related to teeth

• Mandibular

• Suprahyoid

ETIOLOGY

1. Infections of Mandibular 2nd & 3rd molars

2. From sublingual or submental spaces

COMMUNICATIONS

• Submental Space

• Sublingual Space

• Lateral Pharyngeal Space

BOUNDARIES

Submandibular Space

Superiorly Mylohyoid Muscle

AnteriorlySubmetal Space

LaterallySkin

Superficial Fascia Platysma Muscle

Superficial Layer of Deep Cervical Fascia

Lower Border of Mandible

InferiorlyAnterior Belly of Digastric Muscle Posterior belly of Digastric Muscle

PosteriorlyHyoid Bone

MediallyMylohyoid Muscle Hyoglossus Muscle Styloglossus Muscle

CONTENTS

Submandibular Salivary Gland Proximal portion of Wharton’s Duct Submandibular Lymph Nodes Facial Artery & its branches- Palatine,

Tonsillar, Glandular, Submental Lingual Nerve Hypoglossal Nerve Facial Vein

CLINICAL FEATURES

Most common

Location- Angle of the jaw

Trismus

Swelling- Brawny, Indurated, Soft, Fluctuant

Inability to palpate

Lymphadenopathy

DIAGNOSIS

Clinical evaluation

If not obvious, CT is done

MANAGEMENT

Airway Protection

Adequate hydration

Rich nutritional supplements

Treatment of pre-existing disease

Treatment

MEDICAL• Analgesics

* NSAID’s

• Antiseptic Mouth wash

• Antibiotics*Penicillin*Amoxicillin*Ornidazole*Cephalosporins

SURGICAL

• Extraction

• Incision and Drainage

COMPLICATIONS

SialadenitisLudwig’s Angina

Lymphadenitis