Buccal space infections

Revision as of 15:57, 11 September 2011 by Russellm77 (talk | contribs) (Diagnosis)

Background

  • Cellulitis or abscess in buccal space
    • Space between buccinator and superficial fascia/skin
  • Odontogenic source
    • Maxillary second and third molars most common


Diagnosis

  • Ovoid cheek swelling with odontogenic disease
  • CT not always necessary, but can define abscess
  • Differential
    • Parapharyngeal space infxn
      • Swelling of neck and jaw angle,dysphagia,drooling,trismus,nuchal rig
    • Parotitis, bacterial or mumps
    • Neoplasm
    • Trauma
    • Facial cellulitis
    • Canine space infection from infected maxillary canine
      • Suggested by loss of nasolabial fold

Treatment

  • Parenteral Abx coveral oral flora
    • Clindamycin,PCN V,third gen cephalosporin
  • OMFS consult for abscess drainage,if present,and tooth extraction


Disposition

  • OMFS/ENT consult
  • Admit diabetics,immunocompompromised, discuss others with consultant


Source

  • ER Atlas
  • Rosen