File Name: space infections of head and neck .zip
Kataria, G. Iranian Journal of Otorhinolaryngology , 27 4 , Iranian Journal of Otorhinolaryngology , 27, 4, ,
The goal of this chapter is to present the basis for correct diagnosis and management of severe odontogenic infections. The knowledge of the anatomy of fascial spaces is essential for the correct diagnosis and treatment of head and neck infections, because both facial and cervical fasciae work as an effective barrier against the spread of infections in this region[ 1 , 2 ]. Once these infections occur, they are often difficult to assess accurately by clinical examinations and conventional radiographic techniques, and the outcome may be serious and potentially life-threatening[ 3 ]. The fasciae of the neck are glossy and divided into two separated layers: the superficial fascia and the deep fascia. The superficial fascia is actually a component of the fatty subcutaneous tissue while the deep cervical fascia is divided into three layers: the superficial layer, the visceral or middle layer, and the pre vertebral or deep layer. The deep cervical fascia plays an important role in determining the location and course of spread of infections within the soft tissues of the neck. The infections that commonly affect head and cervical areas are frequently from odontogenic origin and to a lesser frequency, proceeding from foreign bodies or trauma to this region[ 4 ].
Odontogenic infection is one of the common infectious diseases in oral and maxillofacial head and neck regions. Clinically, if early odontogenic infections such as acute periapical periodontitis, alveolar abscess, and pericoronitis of wisdom teeth are not treated timely, effectively and correctly, the infected tissue may spread up to the skull and brain, down to the thoracic cavity, abdominal cavity and other areas through the natural potential fascial space in the oral and maxillofacial head and neck. Severe multi-space infections are formed and can eventually lead to life-threatening complications LTCs , such as intracranial infection, pleural effusion, empyema, sepsis and even death. We report a rare case of death in a year-old man with severe odontogenic multi-space infections in the oral and maxillofacial head and neck regions. One week before admission, due to pain in the right lower posterior teeth, the patient placed a cigarette butt dipped in the pesticide "Miehailin" into the "dental cavity" to relieve the pain.
Introduction: The cervical spaces infections compose severe pictures and result in a high degree of mortality when they evolve with complications. Objective: To set up a graduation protocol of the cervical abscesses and organize a sequence to treat these patients. Method: We carried out a retrospective study of patients with cervical abscess in which we evaluated the clinical impression, general state, respiratory state, locoregional state, antibiotics used and comorbidity. Then we organized a classification with severity levels. All Issues. Section: Original Article.
The initial use of penicillin in the therapy of odontogenic infections in the s led to a dramatic decline in the mortality rates for these infections. In the intervening decades, further refinements in diagnosis, airway management, and surgical therapy have rendered serious morbidity and mortality from odontogenic infections so uncommon that death from odontogenic infection is virtually inconceivable to the lay public. The reduced frequency of these infections makes their diagnosis more difficult for the average practitioner, and therefore careful study of severe odontogenic infections is necessary, or preventable deaths can occur. The most common cause of abscesses involving the deep fascial planes of the head and neck is odontogenic infection.
Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding. Deep space infections occur around the airway, including the epiglottis, the parotid gland, and the retropharyngeal spaces retropharyngeal abscesses [RPA] and parapharyngeal spaces.
Fascial spaces also termed fascial tissue spaces  or tissue spaces  are potential spaces that exist between the fasciae and underlying organs and other tissues. The fascial spaces can also be opened during the dissection of a cadaver. The fascial spaces are different from the fasciae themselves, which are bands of connective tissue that surround structures, e.
Deep neck spaces are regions of loose connective tissue filling areas between the 3 layers of deep cervical fascia, namely, superficial, middle, and deep layers. The superficial layer is the investing layer, The pretracheal layer is the intermediate layer and the prevertebral layer is the deepest layer. Deep neck space infection DNI is defined as an infection in the potential spaces and actual fascial planes of the neck. Once the natural resistance of fascial planes is overcome, spread of infection occurs along communicating fascial boundaries. More recent trends include the increasing prevalence of resistant bacterial strains, a decline in DNIs caused by pharyngitis or tonsillitis, and a relative increase in DNIs of odontogenic origin.
Department of oral and Maxillofacial Surgery, Pb. Dental College, Amritsar. Fascial spaces in head and neck find no mention in standard text books of anatomy Williams et al, or Huber, though Hollinshead has described these with some of their clinical aspects. Does it mean that these are not clinically important or their importance has decreased with the advent of antiboitics and so these should not be taught to medical and dental students. Actually it is not so. Neither the patients or abscesses in these spaces have vanished nor have these lost importance. So basic knowledge of these is a must for both medical and dental students For importing this information Faculty of Anatomy including P.
Eight cases treated over a two-year period were reviewed, and the experience was used to formulate management guidelines. Specific clinical variables analyzed included patient presentation, work-up, treatment, complications, and length of hospital stay. Seven of eight cases required surgery for treatment, one of which was complicated by airway obstruction. Treatment of deep-neck space infections requires knowledge of the natural history of the disease and a detailed understanding of anatomy. Management guidelines include 1 hospitalization, 2 culture and sensitivity tests, 3 antibiotic therapy, 4 diagnostic radiographic procedures, and 5 surgical intervention. Stiernberg CM.
Не знаю, почему Фонтейн прикидывается идиотом, но ТРАНСТЕКСТ в опасности. Там происходит что-то очень серьезное. - Мидж. - Он постарался ее успокоить, входя вслед за ней в комнату заседаний к закрытому жалюзи окну.
ОБЪЕКТ: ДЭВИД БЕККЕР - ЛИКВИДИРОВАН Коммандер опустил голову. Его мечте не суждено сбыться. ГЛАВА 104 Сьюзан вышла из комнаты. ОБЪЕКТ: ДЭВИД БЕККЕР - ЛИКВИДИРОВАН Как во сне она направилась к главному выходу из шифровалки. Голос Грега Хейла эхом отдавался в ее сознании: Сьюзан, Стратмор меня убьет, коммандер влюблен в .
Но Пьер Клушар провалился в глубокое забытье. ГЛАВА 23 Сьюзан, сидя в одиночестве в уютном помещении Третьего узла, пила травяной чай с лимоном и ждала результатов запуска Следопыта. Как старшему криптографу ей полагался терминал с самым лучшим обзором.
Халохот переместился ближе к центру, чтобы двигаться быстрее, чувствуя, что уже настигает жертву: всякий раз, пробегая мимо очередного проема, он видел ее тень. Вниз. Скорее .
Пожалуй, дело кончится тем, что его выставят на улицу. Клушар продолжал бушевать: - И этот полицейский из вашего города тоже хорош. Заставил меня сесть на мотоцикл.
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