2. FASCIAL SPACES
• Fascial space is a portion of anatomy that is partially or completely
walled by fascial membrane (fascial layers). Fascial area are potential
areas between layers of fascia.
• Fascial space areas are filled normally with loose connective tissue
which readily breakdown when invaded by infection, leading to a
large swelling.
• Fascial space infections are the most common cause of swellings in
the head and neck region.
• There are 16 fascial spaces of the head and neck region.
4. Superficial fascia
• This fascia lies just under the skin, as it does in the entire body,
invests the superficially situated mimetic muscles (platysma,
orbicularis oculi, and zygomaticus major and minor), and is located in
distinct anatomic areas.
• It is composed of 2 layers, an outer fatty layer and a thin inner
membrane with a large number of elastic fibers.
• The superficial fascia attaches the skin to the deep fascia, which
covers and invests the structures lying deep to the skin while
maintaining the movability of the skin, with the two layers allowing
for separation during blunt dissection.
5. Deep fascia
• The deep fascia begins at the anterior border of the masseter muscle,
attaches to the superior temporal and nuchal lines, and posterior and
inferior to these margins it continues cranially as the pericranium.
• The (1)deep facial fascia represents a continuation of the (2)deep
cervical fascia cephalad into the face and, more posterior, invests the
muscles of mastication.
• The surgical importance lies in the fact that the facial nerve branches
within the cheek lying deep to this fascial layer.
6. Classification of fascial spaces
• Fascial spaces of the face:
1. Canine
2. Buccal
3. Infratemporal
4. Parotid
5. Masticatory spaces - Massetric spaces, Pterygomandibular space,
Temporal space (Zygomaticotemporal space)
7.
8. Classification of fascial spaces
• Suprahyoid fascial spaces:
1. Sublingual space
2. Submental space
3. Submandibular space
4. Lateral pharyngeal space
5. Peritonsillar space
9.
10. Classification of facial spaces
• Infrahyoid fascial spaces:
1. Pretracheal
• Fascial spaces of the neck:
1. Retropharyngeal space
2. Danger space
3. Carotid sheath space
11.
12.
13. Routes for spread of infection from
dentoalveolar infections
• Upper lip
• Canine fossa
• Infraorbital region
• Buccal space (5)
• Palate
• Submasseteric space (3)
• Retropharyngeal
• Lateral pharyngeal (1)
• Pterygomandibibular space (2)
• Infratemporal fossa
• Parotid space
• Buccinator space (4)
• Suprahyoid region –
submandibular space,
submental space, sublingual
space.
14. Direction of spread of infection, and the fascial
spaces involved, from the lower third molar site.
