Mandibular facsial spaces

Done By : Weam Mahmoud faroun
Surgery summer semmester
2017-2018
DonebyDR.WeamMahmoudFaroun

 fasciae are thickened condensations of fibroelastic
connective tissue that separate various movable
structures from one another.
 Spaces between layers of fascia are filled with a
loose type of connective tissue that permits
infection to spread from one locale to another with
relative ease.
 Because infection may travel along these fascial
sheets, the clinician should possess a working
knowledge of their locations, extent, and
intercommunications.

Spaces
related to
lower jaw
Primary Secondary

.PRIMARY MANDIBULAR SPACES
1
• submental
2
• buccal
3
• submandibular.
4
• Sublingual

SUBMENTAL

SUBMENTAL
 The submental space is a fascial space of the head
and neck .
 It is a potential space located between the
mylohyoid muscle superiorly, the platysma muscle
inferiorly, under the chin in the midline.
 The space coincides with the anatomic region
termed the submental triangle, part of the anterior
triangle of the neck.

ANATOMICAL BOUNDARIES
 The boundaries of the submental space are:
 the mylohyoid muscle superiorly
 the investing layer of deep cervical fascia (and this
in turn is covered by the platysma muscle) inferiorly
 the inferior border of the mandible anteriorly
 the hyoid bone posteriorly
 the anterior bellies of the digastric muscleslaterally.
 The midline mesially

COMMUNICATIONS
 The communications of the submental space are:
1. the submandibular spaces posterolaterally.
2. the sublingual space superiorly (via erosion
through the mylohyoid)

CONTENTS
 Its contents are
1. submental lymph nodes
2. areolar connective tissue
3. the anterior jugular veins

BUCCAL

 The buccal space (also termed the buccinator
space) is a fascial space of the head and neck
 It is a potential space in the cheek, and is paired on
each side.
 The buccal space is superficial to the buccinator
muscle and deep to the platysma muscle and the
skin.
 The buccal space is part of subcutaneous space,
which is continuous from head to toe.

ANATOMIC BOUNDARIES
 The boundaries of each buccal space are:
1. the angle of the mouth anteriorly
2. the masseter muscle posteriorly
3. the zygomatic process of the maxilla and the
zygomaticus muscles superiorly
4. the depressor anguli oris muscle and the
attachment of the deep fascia to the mandible
inferiorly
5. the buccinator muscle medially (the buccal space
is superficial to the buccinator)
6. the platysma muscle, subcutaneous tissue and
skin laterally (the space is deep to platysma)

COMMUNICATION
1. to the pterygomandibular space, infratemporal
space, submasseteric space or even to the lateral
pharyngeal space posteriorly
2. to the infraorbital (canine) space superiorly

CONTENTS
 In health it contains
1.the buccal fat pad
2. the parotid duct (Stenson's duct)
3.the anterior facial artery and vein
4. the transverse facial artery and vein

SUBMANDIBUALR

 The submandibular space is a fascial space of the
head and neck
 It is a potential space, and is paired on either side,
located on the superficial surface of the mylohyoid
muscle between the anterior and posterior bellies of
the digastric muscle.
 The space corresponds to the anatomic region
termed the submandibular triangle, part of the
anterior triangle of the neck

THE ANATOMIC BOUNDARIES
 The anatomic boundaries of each submandibular
space are
1. the mylohyoid muscle superiorly
2. the skin, superficial fascia, platysma muscle and
superficial layer of the deep cervical fascia
inferiorly and laterally
3. the medial surface of the mandible anteriorly and
laterally
4. the hyoid bone posteriorly
5. the anterior belly of the digastric muscle medially

COMMUNICATIONS
 The communications of the submandibular space
are:
1.medially and anteriorly to the submental space
(located medial to the paired submandibular
spaces, separated from them by the anterior bellies
of the digastric muscles).
2.posteriorly and superiorly to the sublingual space
(located above the mylohyoid muscle) inferiorly to
the lateral pharyngeal space

CONTENTS
 In health, the contents of the space are:
1. the submandibular gland, which largely fills the
space
2. branches of the facial artery
3. lymph nodes.

SUBLINGUAL

 The sublingual space is a fascial space of the head
and neck
 It is a potential space located below the mouth and
above the mylohyoid muscle, and is part of the
suprahyoid group of fascial spaces.

ANATOMIC BOUNDARIES
 The sublingual space is V-shaped, with the apex
pointing to the anterior.
 Its boundaries are:
1. the mucosa of the floor of mouth and the tongue
superiorly
2. the mylohyoid muscle inferiorly
3. the medial surface of the mandible anteriolaterally
4. the muscles along the base of the tongue (geniohyoid
and genioglossus muscles) posteriorly medially,
5. the intrinsic muscles of the tongue and genioglossus
separate the two halves of the sublingual space.

COMMUNICATION
 The sublingual space communicates:
- posteriorly around the posterior free border of the
mylohyoid muscle with the submandibular space.
- Infections of the sublingual space may also erode
through the mylohyoid, or spread via the lymphatics
to the submandibular and submental spaces.

CONTENTS
 The sublingual space contains
1. a number of blood vessels and nerves, e.g. the
lingual artery and nerve, the hypoglossal nerve
and the glossopharyngeal nerve.
2. the sublingual salivary gland. Saliva from the
sublingual gland drains through several small
excretory ducts in the floor of the
mouth.Sometimes a more distinctive duct can be
recognized, known as Bartholin's duct.
3. the deep part of the submandibular gland and the
submandibular duct (Wharton's duct)
4. some extrinsic tongue musclefibers

SECONDARY MANDIBULAR SPACES
1
• masseteric
2
• pterygomandibular
3
• temporal spaces

MASSETERIC

MASSETERIC
 It is a potential space in the face over the angle of
the jaw, and is paired on eachside.
 It is located between the lateral aspect of the
mandible and the medial aspect of the masseter
muscle and its investing fascia .
 The term masseteric refers to the masseter
muscle.

 the anterior margin of the masseter muscle
anteriorly
 the parotid gland posteriorly
 the zygomatic arch superiorly
 the inferior border of the mandible inferiorly
 the lateral surface of the mandibular ramus medially
 (masseteric space is superficial to the mandible)
 the masseter muscle laterally (the masseteric
space is deep to masseter).

COMMUNICATIONS
 The communications of each masseteric space are:
 to the buccal space anteriorly
 to the pterygomandibular space (around the
posterior margin of the mandibular ramus to its
medial surface) and the parotid space posteriorly
 to the superficial temporal space superiorly .

CONTENTS
 In health, the space contains:
 the masseteric artery
 The masseteric vein.

PTERYGOMANDIBULAR
 It is a potential space in the head and is paired on
each side.
 It is located between the medial pterygoid muscle
and the medial surface of the ramus of the
mandible.

 The boundaries of each pterygomandibular space
are:
 the posterior border of the buccal space anteriorly
 the parotid gland posteriorly
 the lateral pterygoid muscle superiorly
 the inferior border of the mandible (lingual surface)
inferiorly
 the medial pterygoid muscle medially (the space is
superficial to medial pterygoid)
 the ascending ramus of the mandible laterally (the
space is deep to the ramus of the mandible)

COMMUNICATION
 the communications of each pterygomandibular
space are:
 to the buccal space anteriorly
 to the lateral pharyngeal space and peritonsillar
space medially (around the medial pterygoid
muscle).
 to the submasseteric space laterally (around the
ramus of the mandible)
 to the parotid space posteriorly
 to the deep temporal/infratemporal space
superiorly

CONTENT
 In health, the space contains:
1. the mandibular division of the trigeminal nerve
2. the inferior alveolar artery and vein
3. the sphenomandibular ligament.

TEMPORAL SPACES
 Location:
 posterior and superior to the masseteric and
pterygomandibular spaces
 Bounded :
 laterally by the temporalisfascia and medially by the
temporal bone

TWO COMPONENTS:
1.Superficial temporal space:
- located between temporal fascia laterally
- temporalis muscle medially
2.Deep temporal space:
- located between the temporalis muscle laterally
- the temporal bone & greater wing of sphenoid
3.Continuous with the infratemporal space
The infratemporal space is the inferior portion of the
deep temporal space.

SUPERFICIAL TEMPORAL
 Contents
1. Temporal fat pad
2. Temporal branch of facial nerve
 Neighboring spaces :
1. Buccal
2. Deep temporal

INFRATEMPORAL AND DEEP TEMPORAL
 Contents
1. Pterygoid plexus
2. Interior maxillary artery and vein
3. Mandibular devision of trigeminal
4. Skull base foramina
 Neighboring spaces
1. Buccal
2. Superfacial temporal
3. Inferior petrosal sinus

MASTICATOR
 This term is sometimes used, and is a collective
name for the submasseteric (masseteric),
pterygomandibular, superficial temporal and deep
temporal spaces.
 The masticator spaces are paired structures on
either side of the head.
 Communicate freely with one another and are
simultaneously involved
 Each masticator space also contains the sections of
the mandibular division of the trigeminal nerve and
the internal maxillary artery

REFRENCES
 Odell W (2010). Clinical problem solving in dentistry (3rd
ed.). Edinburgh: Churchill Livingstone. pp. 151–153,
229–233.
 Kenneth M. Hargreaves Stephen Cohen ; web, Louis
H.Berman, eds. (2010). Cohen's pathways of the
pulp (10th ed.). St. Louis, Mo.: Mosby Elsevier. pp. 590–
595.
 ^ Norton NS (2007). Netter's Head and Neck Anatomy
for Dentistry. Philadelphia PA: Saunders Elsevier.
pp. 460–472.
 Standring S (2004). Gray's Anatomy: The Anatomical
Basis of Clinical Practice (39th ed.). Elsevier.
 Hupp JR, Ellis E, Tucker MR (2008). Contemporary oral
and maxillofacial surgery (5th ed.). St. Louis, Mo.:
Mosby Elsevier. pp. 317–333.

Mandibular facsial spaces

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