Oral and maxillofacial space infections

Introduction to oral and maxillofacial space infection Oral and maxillofacial space infection is a general term for purulent inflammation of the tissues around the mouth, face and jaw. Infection can affect the maxillofacial skin, mucous membranes, fascia, fat, connective tissue, muscles, nerves, blood vessels, lymph nodes and parotid glands. There is a potential fascial gap in the normal maxillofacial anatomy, each gap being filled with fat and connective tissue. When the infection invades the human body, it destroys the fat and connective tissue, and the gap is filled with inflammatory products. At this time, a gap infection is formed. The infection can be confined to one gap, and can also be scattered in the direction of weak resistance in the tissue structure. A gap creates a diffuse cellulitis. The mutual interaction of the maxillofacial region and the neck region complicates the infection and can cause various serious complications. When the suppurative inflammation is diffused, it is called cellulitis, and when it is limited, it is called abscess. There is a potential fascial space between the layers of the normal maxillofacial region. When the infection invades these gaps, the suppurative inflammation dissolves the loose connective tissue and the inflammatory products are filled with it. At this time, obvious gaps appear. The infection can be confined to one gap, or it can spread through tissues with weak resistance to form diffuse multiple gap infections, such as the mouth. basic knowledge The proportion of illness: 0.0005% Susceptible people: no specific population Mode of infection: non-infectious Complications: sepsis

Oral and maxillofacial space infection

Bacterial infection (60%):

The most common cause of the disease is odontogenic infection, such as pericoronitis, periapical periodontitis, and osteomyelitis of the jaw.

Disease factors (20%):

Followed by glandular infection, can be caused by the spread of tonsillitis, salivary gland inflammation, maxillofacial lymphadenitis, etc., more common in infants and young children.

Secondary infection (10%):

Secondary and traumatic, facial paralysis, oral ulcers and blood-borne infections are rare.

Indirect infection (10%):

The pathogens of the gap infection are mainly hemolytic streptococcus, followed by Staphylococcus aureus, which is often a mixed bacterial infection, and infection caused by anaerobic bacteria is rare.

Prevention of oral and maxillofacial space infection

Oral and maxillofacial infections are common diseases in surgical infections. Clear diagnosis, effective application of antibiotics, and timely incision and drainage are the key to shortening the course of treatment and reducing complications during maxillofacial infection treatment.

Complications of oral and maxillofacial space infection Complications sepsis

Serious complications such as sepsis, sepsis, mediastinal inflammation, etc. may occur.

Symptoms of oral and maxillofacial space infection Common symptoms Loss of appetite, difficulty swallowing, difficulty in opening mouth, infectious fever, leukocytosis

Often expressed as a polar inflammatory process. The nature of the infection may be suppurative or spoilage necrosis; the infection location may be superficial or deep, and may be confined to one gap, or may spread to other gaps through a tissue with less resistance to form a multi-gap infection, thus Have different clinical manifestations. The local manifestations of general purulent infections are redness, swelling, heat, pain and dysfunction. Symptoms of severe inflammation, high fever, chills, dehydration, increased 100-cell count, loss of appetite, general malaise and other symptoms of poisoning. The local red and hot signs of spoilage necrotic infection are not as obvious as purulent infection, but local soft tissue has extensive edema and even subcutaneous emphysema, which can reach the sputum pronunciation.

Symptoms of systemic poisoning are more obvious than purulent infections. Systemic failure can occur in a short period of time. The body temperature and total white blood cells are sometimes lower than normal, and even symptoms such as coma and toxic shock may occur. The clinical symptoms of odontogenic infection are more severe. After multiple secondary and alveolar abscess or osteomyelitis, pus formation occurs early; glandular infection has a slower inflammation, early serous inflammation, then enters suppuration Stage, called glandular cellulitis. Adults have relatively mild symptoms and infants and young children sometimes perform extremely severely. The infection occurs in the superficial gap, and the local signs are extremely obvious. In the deep interstitial infection, due to the dense muscles and fascia around the nucleus and the bottom of the mouth, the local signs are not obvious. Even if the abscess is formed, it is difficult to see the fluctuation, but there is local depression and edema.

Examination of oral and maxillofacial infections

According to the medical history, clinical symptoms and signs, combined with local anatomical knowledge, the total number of white blood cells and the classification and counting, combined with puncture and pus, can make a correct diagnosis. General purulent infection, the pus extracted is colored pus or peach pus, and spoilage necrotic infection, pus thin and dark gray, often have spoilage and necrosis.

Diagnosis and diagnosis of oral and maxillofacial space infection

diagnosis

Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.

Differential diagnosis

It is differentiated from stomatitis and submandibular space infection.

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