Extensive soft tissue swelling secondary to dental disease

Case contributed by Dr Steve Lau

Presentation

Trismus and right submandibular swelling post tooth extraction. No airway compromise clinically.

Patient Data

Age: 55
Gender: Male

CT neck show abnormal low density tissue thickening the parapharyngeal fat and pharyngeal mucosal space extending inferiorly into the hypopharynx. The right piriform sinus is obliterated with extension into pre-epiglottic space. The abnormal soft tissue extends inferiorly, obliterating fat plane at level of false cords on the right. There is no radiological evidence of airway compromise.

The fat surrounding the right sternocleidomastoid muscle is abnormal with some thickening of fascia and platysmus. The right pterygoid muscle is enlarged with diffuse lymphadenopathy.

There is extensive periapical disease around 46 and 47 and also around the left lateral mandibular teeth with caries in the upper left maxillary teeth. 48 has been extracted.

Case Discussion

Patient was managed with intravenous antibiotics. Pus was obtained from dental abscess was cultures and frown Streptocococcus gordonii sensitive to ceftriaxone and penicillin.

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Case Information

rID: 28891
Case created: 20th Apr 2014
Last edited: 26th Sep 2015
System: Head & Neck
Inclusion in quiz mode: Included

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