Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Deep neck space infections

2,185 views

Published on

  • Be the first to comment

Deep neck space infections

  1. 1. Clinical importance: Various spaces in the neck 18 spaces: suprahyoid and infrahyoid Clinically important Intercommunication infection spreads rapidly: cranial cavity, mediastinum
  2. 2. Clinical importance cont.: If not tackle:- Life threatening conditions Acute laryngeal oedema Upper airway compression Involvement of great vessels, cranial nerves Severe odynophagia
  3. 3. Important Deep Neck Spaces: 1. Peritonsillar space 2. Submaxillary space: sublingual space submandibular space 3. Retropharyngeal space 4. Parapharyngeal space 5. Parotid space 6. Masseteric space 7. Pre-epiglottic & para-glottic space.
  4. 4. Peritonsillar space: Boundary: laterally : superior constrictor medially : tonsillar capsule Infection: peritonsillitis-> Abscess (quinsy) Pathology : as an complication & : de novo
  5. 5. Peritonsillar space cont.: s/s: Pain more severe & unilateral Muffled sound (hot potatoes sound) Trismus Drooling of saliva Inflamed soft palate Buried tonsils Enlarged and tender JD node
  6. 6. Management of peritonsillitis: Diagnosis: clinically, aspiration of abscess Treatment: I/V Ampicillin + cloxacillin & metronidazole Anti-inflammatory: Ibuprofen & paracetamol Locally antiseptic mouth wash If abscess: I & D of abscess (site of drainage) If second attack: tonsillectomy.
  7. 7. Submaxillary space: Boundary: Superior : mucosa of floor of mouth Inferior : deep fascia of neck Divided by myelohyoid muscle Content: submandibular and sublingual salivary glands, lymph nodes.
  8. 8. Sub maxillary space cont: Ludwigs angina (inflammation of floor of mouth):- Browny Induration Pathology: Dental origin(80%) Inflammation of submandibular salivary gland Lymphadenitis Trauma floor of mouth
  9. 9. Ludwig’s Angina
  10. 10. Submaxillary space cont.: S/S: pain Swelling of floor of mouth Submandibular & submental region Trismus Diagnosis: clinically Treatment: Conservative : Antibiotics : Anti-inflammatory : local antiseptic mouth wash
  11. 11. Submaxillary space cont.: Surgical treatment: Incision and drainage: wide incision Greety sensation No pus: usually inflammatory fluid & necrotic tissue NB: always pierce myelohyoid muscle.
  12. 12. Retropharyngeal space: Boundary: Superior : base of skull Inferior : posterior mediastinum Posterior : pre-vertebral fascia Anterior : bucopharyngeal fascia Content: Lymph nodes, loose aerolar tissues. Pathology:suppuration RP lymph node (Rouviere) :Koch’s spine :Pharyngeal trauma :From other neck spaces
  13. 13. Retropharyngeal space cont: S/S: Pain, fever Odynophagia Drooling of saliva Stertor: respiratory obstruction o/e: bulging of posterior pharyngeal wall X-ray soft tissues neck lateral view: increase prevertebral soft tissue density.
  14. 14. Retropharyngeal space cont: Treatment: Conservative: Antibiotics Anti-inflammatory+ supportive therapy Surgical: I&D of most bulging area through trans-oral route Anaesthesia: blanket anaesthesia Position: head down and lateral position
  15. 15. Parapharyngeal space: Boundary: Superior : base of skull Inferior : Hyoid bone Medial : pharynx Lateral : mandible content: great vessels, last 4 cranial nerves, lymph nodes, deep lobe of parotid.
  16. 16. Parapharyngeal space cont: S/S:  Pain, fever, odynophagia Drooling of saliva Stertor - respiratory obstruction O/E: lateral neck swelling bulging of lateral pharyngeal wall pseudo enlargement of tonsils
  17. 17. Parapharyngeal space cont: Treatment: Conservative: Antibiotics Anti-inflammatory + supportive therapy Surgical: I&D of most bulging area lateral side of neck (external route) Anaesthesia: LA or GA Position: head turn and lateral position

×