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Deep spaces of the head and neck

Dr Francis Deng and Dr Samuel Wong et al.

The deep spaces of the head and neck refer to compartments delimited by the deep cervical fascia. While these concepts overlap with traditional anatomical description, their existence highlights the importance of fascia in confining various pathologies.

A knowledge of these spaces not only allows for better communication between radiologists and specialists familiar with imaging of this region but also aid in diagnosis as each space has a distinct group of pathologies.

Gross anatomy

Three layers of deep cervical fascia form the boundaries of the deep spaces in the neck ^5,6:

superficial layer: investing fascia of the sternocleidomastoid and trapezius muscles, fascia of the muscles of mastication, fascia between the hyoid and mandible that forms the floor of the submandibular space, at least some of the fascia covering the parotid gland
middle layer: strap muscle fascia, visceral fascia that encloses the thyroid gland and aerodigestive tract (pharynx, larynx, trachea, esophagus)
deep layer: perivertebral fascia of the prevertebral and paraspinal muscles, alar fascia

All three layers contribute to the carotid sheath.

Contents

The compartmental definitions vary somewhat by source ^1,5,6. They may be arbitrarily divided into suprahyoid spaces (between the base of the skull and hyoid bone) and infrahyoid spaces (between the hyoid bone and clavicles), although there is some overlap.

suprahyoid neck
- parotid space
- masticator space, including or contiguous with buccal space
- submandibular space, including or contiguous with sublingual space and submental space
- parapharyngeal space (prestyloid parapharyngeal space)
suprahyoid and infrahyoid neck
- carotid space (poststyloid parapharyngeal space)
- visceral space, including or contiguous with pharyngeal mucosal space
- retropharyngeal space, including or contiguous with danger space
- perivertebral space, including prevertebral space
- posterior cervical space
infrahyoid neck
- anterior cervical space

Relations

parapharyngeal space lies in a central location on each side of the deep face and suprahyoid neck
visceral/pharyngeal mucosal space is medial to the parapharyngeal space
submandibular space is anterior to the parapharyngeal space
masticator space is anterolateral to the parapharyngeal space
parotid space is lateral to the parapharyngeal space
carotid (poststyloid parapharyngeal) space is posterior to the parapharyngeal space
retropharyngeal space is posteromedial to parapharyngeal space
perivertebral space is posterior to the retropharyngeal space

Related pathology

Many of the disease states that affect the deep structures of the head and neck are confined to one compartment. However, there are some diseases that are trans-spatial. A list of differentials for related pathology can be found in the article for each individual space.

References

Anatomy: Head and neck

Article information

rID: 28580

System: Head & Neck

Section: Anatomy

Tag: cases

Synonyms or Alternate Spellings:

Deep compartments of the head and neck

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Cases and figures

Figure 1: annotated MRI Figure 1: annotated MRI

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