暂无摘要。

Metastasis to the masticator space and mandible is very rare. The most common origin in women is breast cancer. Cystic metastases may radiologically mimic abscess. Definitive diagnosis can be made histopathologically. The prognosis of these patients is very poor and early diagnosis is important. Therefore, metastasis should be considered in the differential diagnosis of oral lesions.

OBJECTIVE: We have attempted to characterize the clinical presentations and management of infratemporal fossa abscesses with the goal of improving awareness and promoting earlier diagnosis and treatment for this rare condition.
METHODS: an extensive systematic search was performed through Pubmed/Medline, CINAHL (EBSCOhost), and Web of Science. Two authors screened out studies by abstracts, and a third resolved any conflicts. The remaining studies were assessed by full-text assessment, leaving 43 studies for data extraction.
RESULTS: sixty-seven patients were included from the final 43 studies. The patients were predominantly male (56.7%), and the average age of patients was 44.3 years (standard deviation (SD) 19.8 years). Risk factors most commonly odontogenic, whether the etiology was through tooth extraction (n = 30, 44.8%) or infection (n = 17, 25.4%). Symptoms on presentation included pain (n = 40, 83.3%), swelling (n = 39, 81.3%), and trismus (n = 36, 75.0%). Twenty-two (32.8%) patients were managed with intraoral incision and drainage (I&D), 18 (26.9%) with extraoral I&D. After treatment, 45 of the 48 (93.8%) patients from the case reports and series were deemed to have achieved complete resolution.
CONCLUSIONS: Infratemporal fossa abscesses are rare, but they may be associated with serious neurologic and systemic complications. Although prompt diagnosis paramount in avoiding these sequelae, patients often experienced delays in diagnosis. Surgical drainage and extended antibiotic therapy is recommended.

UNASSIGNED: Parapharyngeal space infection may lead to severe and potentially life-threatening complications. The aim of this study was to assess the odontogenic infection pathway to the parapharyngeal space using CT imaging.
UNASSIGNED: Nineteen patients in mandibular odontogenic infections with abscess who underwent contrast-enhanced CT were evaluated in this study. We reviewed the location of abscess and spread of odontogenic infections to the different components of the buccal space, submandibular space, sublingual space, masticator space and parapharyngeal space using CT imaging. The location of abscess and spread of odontogenic infections were analyzed with the Pearson Chi-square test.
UNASSIGNED: Regarding the odontogenic infection pathway to parapharyngeal space, the masticator space (100%) was the most frequent, followed by the buccal space (85.7%), submandibular space (85.7%) and sublingual space (57.1%), while those without parapharyngeal space, the submandibular space (83.3%) was the most frequent, followed by the buccal space (75.0%), masticator space (58.3%) and sublingual space (33.3%). The masticator space was significant space in patients with/without parapharyngeal space infection (P = 0.047).
UNASSIGNED: CT imaging could be an effective method in assessment of odontogenic infection pathway to the parapharyngeal space. The odontogenic infection in masticator space tends to display spread of parapharyngeal space.

BACKGROUND: Masticator space involvement in oral cavity squamous cell carcinoma (OCSCC) is considered an unresectable disease. Nevertheless, achieving negative resection margins is feasible in limited masticatory space involvement.
METHODS: A multi-institutional study on OCSCC patients with masticator space invasion who underwent surgical resection. Margin status was assessed according to anatomic tumor involvement of the inframandibular and supra-mandibular notch.
RESULTS: One-hundred and thirty-two patients met the inclusion criteria. Then, 67 patients (50.8%) were diagnosed with a supra-notch tumor and 65 (49.2%) with an infra-notch disease. Negative margins were more common in the infra-notch group (43.3 vs. 23.1%, p = 0.014), and positive margins were more common in the supra-notch group (41.5 vs. 23.9%, p = 0.041). Multivariable analysis demonstrated that supra-notch tumors had an increased likelihood for involved resection margins (odds ratio = 2.46, p = 0.036).
CONCLUSIONS: OCSCC patients with masticator space involvement are prone for positive surgical margins in tumors extending above the supra-mandibular notch.

暂无摘要。

Odontogenic myxomas are an uncommon benign odontogenic tumor that can present with a wide variety of symptomatology depending on location and potentially be locally destructive. The present case describes a 66-year-old female who presented with left lower facial paresthesia, left aural fullness and hearing loss. She was found to have an odontogenic myxoma that involved the condylar head and extended into the masticator space. In this report we detail our surgical approach utilizing a preauricular transfacial transmandibular approach to the masticator space. In addition, we will discuss various approaches to the masticator space and infratemporal fossa along with considerations on how to manage facial nerve paralysis, facial contour deformities, and post-operative rehabilitation for permanent unilateral condylar head disarticulation.

Oral squamous cell cancers involving the masticatory space are staged as unresectable cancers and their treatment is difficult. Curative treatment with extensive surgery followed by adjuvant therapy is one of the treatment options. In this retrospective study, the survival of 123 patients (93 with T4a cancers, 30 with T4b cancers), treated during the period August 2009 to August 2015, was evaluated. The majority had bucco-alveolar cancers (62.6%), were male (61.8%), and were tobacco users (76.4%). The select group of T4b oral cancer patients were treated with surgery, which included infratemporal fossa clearance in all 30 patients, followed by adjuvant therapy. The masseter was the most commonly involved masticatory muscle, and 24 patients had fewer than three involved structures. Free margins were obtained in 90.2% of cases; 41.5% of cases were node-positive. One hundred and four patients (84.6%) completed adjuvant treatment. The median follow-up was 42 months. For node-negative patients with T4a and T4b cancers, the 5-year overall survival was 59% and 50.2%, respectively (P= 0.62), and 5-year disease-free survival was 64.6% and 53.5%, respectively (P= 0.01). In conclusion, the select group of patients with T4b oral cancers and less than three masticatory space structures involved had comparable outcomes to those with T4a cancers after treatment with surgery and adjuvant radiotherapy.

Patients may present in the emergency setting for a variety of head and neck complaints such as fever, trouble swallowing, or a newly palpable mass. When reviewing radiologic head and neck exams for etiology of complaints, it is important to be familiar with the multiple pseudolesions that may mimic pathology. These may be normal variant anatomy, normal anatomy located in an atypical location, as well as iatrogenic or self-introduced foreign bodies. This review article discusses ten common pseudolesions encountered in the head and neck and their typical imaging appearance so that one does not mistake them for ominous pathology, thus preventing unnecessary follow-up, biopsy, or continued concern for the patient.

To examine survival endpoints in patients with tumor (T)4b oral cavity squamous cell carcinoma (OCSCC) with pathologically proven masticator space invasion treated with primary surgery followed by adjuvant therapy.
Retrospective review at an academic cancer center.
Twenty-five patients with T4b OCSCC with pathologic masticator space invasion were treated with primary surgery from May 2012 to December 2016. Only patients with ≥ 2 years follow-up from date of surgery were included. Sixteen patients received adjuvant chemoradiation.
Median follow-up time was 39 months from date of surgery. Overall survival (OS), disease-specific survival (DSS), and recurrence-free survival at 24 months were 44.0%, 63.2%, and 52.6%, respectively. On univariate analyses, adjuvant chemoradiation was associated with improved OS. Advanced age and prolonged length of hospital stay was associated with worse OS.
For pT4b OCSCCA involving the masticator space, primary surgical resection followed by adjuvant chemoradiation demonstrates 24-month DSS of > 50% and OS of 44%.
4 Laryngoscope, 131:E466-E472, 2021.