摘要
Once a submasseteric space infection is diagnosed, the key to resolving the infection is via surgical intervention to evacuate the pus. Although it is possible and occasionally practical to drain the submasseteric space via an intraoral approach, an extraoral approach may sometimes be required. Surgeons have encountered complications such as facial nerve damage during extraoral incision and drainage procedures, and they have felt that extraoral dissection was very difficult. As such, an easier and simpler technique is needed. Our department recently modified various drainage techniques for submasseteric space abscesses. Damage to the marginal branch of the facial nerve did not occur, and this technique was very simple and rapid, such that a novice physician could perform this procedure. This modified technique was possible with trismus and under local anesthesia. After intraorally checking the position of the drain, the intraoral wound is closed with an absorbable suture and the drain is fixed to the extraoral skin. When a masseteric space infection is diagnosed, multiple space involvement is ruled out, and dependent drainage is required, this modified drainage technique can be useful.
Subject(s)
Abscess , Anesthesia, Local , Drainage , Facial Nerve , Skin , Suppuration , Surgeons , Sutures , Trismus , Wounds and Injuries摘要
Wernicke's encephalopathy is a fatal neurological disease caused by thiamine deficiency. Many reports indicate that Wernicke's encephalopathy is caused by malnutrition. We report the case of a 79-year-old female patient who had a left masticator space and parapharyngeal space abscess who was diagnosed with Wernicke's encephalopathy. She reported problems while eating due to the presence of the abscess, but the true quantities of food she was ingesting were never assessed. Clinicians have a responsibility to provide adequate nutritional support by ensuring that patients receive adequate nutrition. Clinicians should also keep in mind that Wernicke's encephalopathy may occur in patients who experienced prolonged periods of malnutrition.
Subject(s)
Aged , Female , Humans , Abscess , Eating , Malnutrition , Nutritional Support , Parenteral Nutrition , Thiamine Deficiency , Wernicke Encephalopathy摘要
Subject(s)
Airway Obstruction , Anti-Bacterial Agents , Drainage , Early Diagnosis , Fasciitis, Necrotizing , Gangrene , Head , Hemorrhage , Mediastinum , Neck , Skin , Vascular System Injuries摘要
Odontogenic infections are a normally locally confined, self-limiting process that is easily treated by antibiotic therapy and local surgical treatment. However, it may spread into the surrounding tissues through a perforation of the bone, and into contiguous fascial spaces or planes like the primary or secondary fascial spaces. If the infection extends widely, it may spread into the lateral pharyngeal and retropharyngeal space. The retropharyngeal space is located posterior to the pharynx. If an odontogenic infection spreads into this space, severe life-threatening complications will occur, such as airway obstruction, mediastinitis, pericarditis, pleurisy, pulmonary abscess, aspiration pneumonia and hematogenous dissemination to the distant organs. The mortality rate of mediastinitis ranges from 35% to 50%. Therefore, a rapid evaluation and treatment are essential for treating retropharyngeal space abscesses and preventing severe complications. Recently, we encountered two cases of a retropharyngeal space abscess due to the spread of an odontogenic infection. In all patients, early diagnosis was performed by computed tomography scanning and a physical examination. All patients were treated successfully by extensive surgical and antibiotic therapy.
Subject(s)
Humans , Abscess , Airway Obstruction , Early Diagnosis , Lung Abscess , Mediastinitis , Pericarditis , Pharynx , Physical Examination , Pleurisy , Pneumonia, Aspiration摘要
The mucocele of paranasal sinuses is a mucus-filled, epithelial-lined cystic structure resulting from the destruction of the sinus ostia secondary by recurrent inflammation, trauma or intrinsic disease. A 42-year-old man was presented with a left periorbital swelling that developed 7 days ago. CT scan revealed mass lesions with soft tissue density in the left anterior ethmoid and frontal sinus. MRI showed a well- demarcated cystic mass in the left anterior ethmoid sinus with a high signal on both the T1-weighted and T2-weighted images as well as in the left frontal sinus with a low signal on the T1-weighted images and a high signal on the T2- weighted images. The patient subsequently underwent the removal of the left anterior ethmoid and frontal mucocele via a Lynch's approach and a left endoscopic anterior ethmoidectomy. He has no recurrence 6 months after surgery.