Odontogenic right submandibular abscess

Case contributed by Dr Craig Hacking

Presentation

Right submandibular pain and swelling.

Patient Data

Age: 36
Gender: Male

Small fluid and gas density collection in the right masticator space between the ramus of the mandible and the inflamed enlarged masseter muscle. The collection measures 1 cm and abuts the outer cortex of the mandibular ramus which is intact. There is very little submandibular extension. Gross inflammatory changes extend anteriorly, with no fluid component detected. The parotid and submandibular salivary glands are normal. The infection is secondary to lucency within the empty tooth sockets of 47 and 48, which communicate with the root of 46. There is bony erosion medial to the lucency however there is no stranding or collection medial to the ramus. The parapharyngeal fat spaces are preserved.

A few right submandibular lymph nodes are prominent. No lymphadenopathy elsewhere. The right jugular vein opacifies normally. Incidental left thyroid low-density nodule. No intracranial pathology evident.

Conclusion

Right masticator space infection and small abscess abutting the mandibular ramus secondary to mandibular infection within the empty tooth sockets of 47 and 48, communicating with a root of 46.

There is evidence of recent lower right molar extraction. No definite evidence of bone destruction is identified.

 

Case Discussion

Dental infection is one of the most common causes of submandibular swelling and pain. In any masticator or submandibular space pathoological process, care must be taken to fully evulate the mandible and maxilla in bone windows to identify a dental source of infection.

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Case information

rID: 34698
Case created: 5th Mar 2015
Last edited: 9th Feb 2017
System: Head & Neck
Inclusion in quiz mode: Included

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