Infra temporal space infection ppt
- 1. INFRA TEMPORAL SPACE INFECTION PRESENTED BY AILEEN THANKACHAN K 3rd BDS KVG DC
- 2. CONTENTS .INTRODUCTION .CLASSIFICATIONS OF FACIAL SPACES .ANATOMICAL BOUNDARIES OF INFRA TEMPORAL SPACES .CONTENTS OF INFRATEMPORAL SPACES .SOURCES OF INFECTION .CLINICAL FEATURES .SPREAD OF INFECTION .COMPLICATION .TREATMENT .CONCLUSION .REFERENCE
- 3. INTRODUCTION Fascial spaces are potential spaces between various layers of fascia normally filled with loose connective tissue and bounded by anatomical barriors,usually ofbone,muscles or fascial layers Fascia is described under :- 1) Superfical fascia 2) Deep fascia .Superfical fascia :-ensheathes platysma and muscles of fascial expressions
- 4. Deep fascia:- a) superfical or anterior or investing layer b)middle or pretracheal layer c) posterior or prevertebral layer d) carotid sheath : The infections in orofacial region tends to accumulate in these potential spaces around head and neck. Many of these spaces communicate witheach other - SPACE INFECTIONS
- 7. INFRA TEMPORAL SPACES - Space posterior to maxilla BOUNDARIES Medial –Lateral pterygoid plate of the sphenoidbone Superior – Base of skull Lateral- continuous with the deeptemporal spaces SYNONYM: Retrozygomztic space
- 9. CONTENTS OF INFRA TEMPORAL SPACE Pterygoid plexus Maxillary artery and veins Mandibular nerves Chorda tympani Otic Ganglion .Medial Pterygoid muscle
- 10. ETIOLOGY It is rarely infected Cause is usually an infection of maxillary molars Especially 3rd molar Spread of infection from pterygomandibular,parotid or lateral pharyngeal region local anesthesia injections with Contaminated needle in area of tuberosity
- 11. CLINICAL FEATURES Extra oral : trismus bulging of temporalis muscle swelling of face infront of ear,overTMJ behind zygomatic process Intra oral: swelling in tube rosity area elevated temp upto140 degree
- 13. SPREAD OF INFECTION Extend upwards to involve temporal space. Inferiorly –pterygomandibular space. It can spread through pterygoid plexus veins Upwards into cavernous sinus *From infratemporal fossa to Middle cranial fossa
- 15. MANAGEMENT MEDICAL SUPPORT TO THE PATIENT 1.Rehydrate pt.as dehydration may be present 2.Treat conditions that predispose pt . To infections (DM) 3. oral pain,trismus and swelling can be addressed by appropriate analgesia and treatment undelying infections.
- 16. NON – SURGICAL APPROACH * INTRAVENOUS ANTIBIOTICS Early infections(first 3 dayof symptoms or mild immunocompromised pt) Rx. Pencillin Clindamycin Cephalexin (or other 1 st gen cephalosporin)
- 17. Late infections( after 5 days of symptoms or severe immunocompromised pt.) Rx Clindamycin Pencillin and metronidazole Ampicillin Cephalosporin( 1st or 2nd gen)
- 18. INCISION & DRAINAGE * Intra oral approach : incision is given in buccal vestibule opposite of 2 nd and 3rd molar exploration is carried out medial to coronoid process and temporalis muscle upwards backwards with sinus forcep ,space is entered and drained
- 19. * Extra oral approach: incision is madeat upperand posterior edge of temporalis muscle within hairline.sinus foceps directed upward medially.pus is evacuated Infratemporal space Hilton method Lister sinus forceps
- 20. COMPLICATION 1. Brain Abcess 2. Meningitis 3.Cavernous sinus thrombosis 4.Multiple space involment 5.Hemorrhage 6.sepsis
- 21. CONCLUSION Incidence and severity have diminished with advent of medical therapy Deep fascial infection must be recognized promptly and treated as an emergency Repeat diagnostic and therapeutic measures may be necessary until the very end point Identify possible complications Resolve the associated infection A through knowledge of anatomy of face and neck is necessary to predict pathway of spread of infection and its drainage
- 22. REFERENCE Textbook of oral &maxillofacial surgery-Neelima Malik Textbook of Human Anatomy – BD Chaurasia Shafer’s Textbook of Oral pathology 8th edition