Presentation
Firm left submandibular swelling, worsening over two weeks. Poor dentition. ? collection for drainage
Patient Data
Large abscess. with flecks of gas, involving the left masseter, surrounding the mandibular ramus and extending into the left submandibular space. No extension of the collection superior to the zygoma.
Multiple carious teeth, with lingual cortical erosion adjacent to LL7 communicating with the abscess. Associated reactive mandibular hyperostosis.
The left submandibular gland is displaced medially, as is the orophayrnx and cartilaginous complex, but no other spread. Reactive lymph nodes.
Case Discussion
Large dental abscess, containing gas, with reactive hyperostosis of the mandible. LL7 was removed and the abscess was drained surgcially, with positive Streptococcus cultures.