口腔颌面外科学（中山大学）12.颌骨骨髓炎.pptxVIP

Oral and Maxillofacial InfectionLiang Yu-jie Department of oral and maxillofacial surgeryGuanghua school of stomatologyInfection of parapharyngeal spaceSuperior: the petrous portion of the temporal bone with the foramen lacerum and jugular foramen Inferior: the stylohyoid muscle and posterior belly of the digastricus.Lateral: the mandible, medial pterygoid muscle, and retromandibular portion of parotid glandMedial: the superior constrictor muscle of pharynxPosterior: the apposition of the prevertebral and visceral layers of the deep cervical fasciaAnterior: the pterygomandibular rapheInfection of parapharyngeal space This space subdivided into two compartments by the styloid processanterior lymph nodes (part of the deep cervical group) the ascending pharyngeal and fascial arteries loose areolar connective tissueposterior internal carotid artery internal jugular vein vagus nerve glossopharyngeal accessory hypoglossal nerves the cervical lymph nodesInfectious originodontogenic infectionspalatine tonsillitis, pharyngitis, otitis, or mastoiditis, parotid gland，the retropharyngeal space, and deep cervical lymph nodesOften two compartments involved simultaneously Clinical featuresSerious，often a direct threat to life Anterior compartmentmedial bulging of the lateral pharyngeal wall, and pushes the palatine tonsil together with the soft palate toward the midlineexternal swelling occurs anterior to the sternocleidomastoid muscle, can extends upward over the parotid regiontrismus and pain are particularly severe, fever, chills, dysphagia Clinical features Posterior compartmentnot have trismus or swelling at the angle of the mandibleinternal swelling involves the lateral wall of the pharynx behind the palatopharyngeal archrespiratory difficulties, feverformation of septic thrombosis of the jugular vein, erosion of one of the great vessels of the neckipsilateral Homer syndrome, and palsies of the ninth through twelfth cranial nervesComplicationsRespiratory paralysis re