Masticator space abscess - dental origin

Case contributed by Dr Derek Smith

Presentation

Right facial swelling. Whole parotid feels swollen. Known right submandibular calculus and unerupted RL8 tooth.

Patient Data

Age: 40 years
Gender: Male

Unerupted carious RL8 tooth with periapical lucency extending into the inferior alveolar canal, with erosions of both the buccal and lingual cortices of the mandible. Sclerosis and periosteal reaction of the mandibular ramus. There is also a small cortical defect in the right mandibular condyle.

Immediately overlying the buccal cortex defect there is a submasseteric abscess, spreading through the masticator space. The right masseter is enlarged and there is retromaxiallary stranding, with reactive platysmal thickening inferiorly, but no deep neck space collection. No parotid collection.

Known incidental right submandibular calculus between mylohyoid and hyoglossus, but no duct dilatation nor submandibular gland enlargement.

No left sided abnormality.

Case Discussion

With dental infections it is important to examine the masticator space for any submasseteric collections which can be clinically hidden.

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Case information

rID: 77671
Published: 19th May 2020
Last edited: 26th Oct 2020
System: Head & Neck
Inclusion in quiz mode: Included

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