fascial spaces

  • 文章类型: Case Reports
    面部坏死性筋膜炎(NF)是一种罕见但严重的疾病,需要及时和全面的治疗。这种方法通常涉及各种医学专业的输入,如传染病专家,重症监护医生,还有外科医生.首要目标是尽早承认,积极的手术清创术,适当的抗生素治疗,和支持性护理。及时诊断至关重要,根据剧烈疼痛等症状,迅速蔓延的红斑,和全身感染的迹象。广谱抗生素是凭经验启动的,并根据文化结果进行调整。紧急手术清创至关重要,清除所有坏死组织。必须仔细考虑保护重要结构。密切监测和重症监护可能是必要的,特别是对于严重的病例。一旦感染得到控制,可以进行软组织重建,旨在恢复功能和美学。长期随访对观察并发症和复发至关重要。
    Necrotizing fasciitis (NF) of the face is a rare yet serious condition requiring prompt and comprehensive management. This approach typically involves input from various medical specialties such as infectious disease specialists, critical care physicians, and surgeons. The primary goals are early recognition, aggressive surgical debridement, appropriate antibiotic therapy, and supportive care. Prompt diagnosis is crucial, based on symptoms like severe pain, rapidly spreading erythema, and systemic signs of infection. Broad-spectrum antibiotics are initiated empirically, and adjusted based on culture results. Urgent surgical debridement is crucial, removing all necrotic tissue. Careful consideration must be given to preserve vital structures. Close monitoring and intensive care may be necessary, especially for severe cases. Soft tissue reconstruction may follow once the infection is controlled, aiming to restore function and aesthetics. Long-term follow-up is essential to observe for complications and recurrence.
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  • 文章类型: Journal Article
    背景:牙源性感染在大多数情况下是常见的和自限性的;然而,会导致严重的后果,相当高的发病率,甚至可能是致命的,尽管现代医学治疗。患者和方法:这项回顾性研究包括颌面外科治疗的严重深筋膜间隙感染患者,普外科,医学院,Sohag大学,Sohag省,埃及,和口腔颌面外科,法赫德国王专科医院(三级转诊中心),Burayda市,卡西姆省,沙特阿拉伯,从2017年6月到2022年6月。结果:本研究共纳入296例患者,男性161人(54.4%),女性135人(45.6%)。生命的第五个十年是最常见的脆弱年龄组。43%的患者患有糖尿病,26.6%为高血压,13.3%接受长期类固醇治疗.在83%的患者中,发现了有问题的牙齿,但在17%的患者中,没有发现牙齿原因。最常见的是下第三磨牙。69例(23.3%)患者存在颌下间隙感染。53例(17.9%)患者患有犬间隙感染。30例(10.1%)患者发生了咬下间隙感染。28例(9.5%)患者患有下间隙感染。23例(7.8%)患者出现咬肌下联合感染,颌下,翼状下颌空间,而19例(6.4%)患者出现路德维希心绞痛。结论:牙源性感染很常见。颌下间隙是最常见的单个空间。这些感染可能导致免疫功能低下患者的致命并发症,尤其是糖尿病患者。这些感染需要紧急手术干预以减少住院时间并避免潜在的致命并发症。
    Background: Odontogenic infections are common and self-limiting in most cases; however, they can lead to severe consequences, considerable morbidity and can even be fatal despite modern medical therapy. Patients and Methods: This retrospective study included patients with severe deep fascial space infections treated in the Maxillofacial Surgery Unit, General Surgery Department, Faculty of Medicine, Sohag University, Sohag Governorate, Egypt, and the Department of Oral and Maxillofacial Surgery, King Fahd Specialist Hospital (tertiary referral center), Burayda City, Qassim Province, Saudi Arabia, from June 2017 to June 2022. Results: This study included 296 patients, 161 (54.4%) males, 135 (45.6%) females. The fifth decade of life was the most common vulnerable age group. Forty-three percent of patients had diabetes mellitus, 26.6% were hypertensive, and 13.3% were on long-term steroid therapy. In 83% of patients, the offending tooth was identified but in 17% of patients no dental cause was identified. The lower third molar tooth was most commonly involved. Sixty-nine (23.3%) patients had submandibular space infections. Fifty-three (17.9%) patients had canine space infections. Thirty (10.1%) patients had submasseteric space infection. Twenty-eight (9.5%) patients had submental space infections. Twenty-three (7.8%) patients had combined infection of the submasseteric, submandibular, and pterygomandibular spaces, whereas 19 (6.4%) patients presented with Ludwig\'s angina. Conclusions: Odontogenic infections are common. The submandibular space is the most commonly affected single space. These infections could lead to lethal complications in immunocompromised patients, especially patients with diabetes mellitus. These infections require urgent surgical intervention to decrease hospital stays and avoid potentially lethal complications.
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  • 文章类型: Case Reports
    可注射软组织填充物的感染可能涉及筋膜间隙,并且看起来类似于牙源性脓肿。该病例报告涉及一名32岁的女性面部肿胀患者,该患者被转诊至牙髓科治疗疑似牙源性感染。
    Infection of an injectable soft tissue filler may involve fascial spaces and appears similar to an odontogenic abscess. This case report addresses a 32-year-old female patient with facial swelling who was referred to the department of endodontics for the treatment of a suspected odontogenic infection.
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  • 文章类型: Journal Article
    未经证实:咽旁间隙感染可能导致严重和潜在危及生命的并发症。这项研究的目的是使用CT成像评估牙源性感染到咽旁间隙的途径。
    UNASSIGNED:本研究对19例下颌牙源性感染伴脓肿患者进行了对比增强CT评估。我们回顾了脓肿的位置和牙源性感染扩散到颊间隙的不同组成部分,颌下间隙,舌下空间,使用CT成像的咀嚼空间和咽旁间隙。用Pearson卡方检验分析脓肿的位置和牙源性感染的扩散。
    UNASSIGNED:关于牙源性感染途径到咽旁间隙,咀嚼器空间(100%)是最频繁的,其次是颊间隙(85.7%),颌下间隙(85.7%)和舌下间隙(57.1%),而那些没有咽旁间隙的人,颌下间隙(83.3%)是最常见的,其次是颊间隙(75.0%),咀嚼空间(58.3%)和舌下空间(33.3%)。在有/没有咽旁间隙感染的患者中,咀嚼空间是显着的空间(P=0.047)。
    UNASSIGNED:CT成像可能是评估牙源性感染途径到咽旁间隙的有效方法。咀嚼空间的牙源性感染倾向于显示咽旁间隙的扩散。
    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.
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  • 文章类型: Case Reports
    皮下面部气肿(SFE)是牙科治疗的潜在严重并发症,通常与使用气动手持件进行手术拔除牙齿有关。在常规牙科修复后出现SFE病例,以及一个框架,以帮助预防这种并发症和指导管理发生。
    Subcutaneous facial emphysema (SFE) is a potentially serious complication of dental treatment typically associated with surgical removal of teeth using air-driven handpieces. A case of SFE is presented occurring after routine dental restoration, along with a framework to aid prevention of this complication and guide management where it occurs.
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  • 文章类型: Journal Article
    BACKGROUND: Odontogenic infections are the most commonly encountered orofacial infections, which may spread into the adjacent anatomical spaces along the contiguous fascial planes, leading to involvement of multiple spaces which can progress to life-threatening situations.
    METHODS: A prospective study was carried out on 100 consecutive cases of odontogenic infections treated at our institute over a period of 18 months by surgical intervention and intravenous antibiotics. Morphologic study of the isolates and antibiotic sensitivity testing was performed.
    RESULTS: Caries was the most frequent dental disease (53.27%), and the mandibular first molar was the most frequently involved tooth (41.9%) associated with the etiology of odontogenic infections. A total of 158 spaces were involved in 100 patients. In subjects with single space odontogenic infections (n = 61), submandibular space was most commonly affected (44.26%) followed by buccal space (27%). In subjects with multiple space infections (n = 39), submandibular space (30.19%) was most frequently involved followed by buccal space (17.92%). In the aerobic group/microaerophilic group, 17 different species were isolated in a total of 102 aerobic isolates. A total of 18 species were identified in 65 anaerobic isolates sampled.
    CONCLUSIONS: Amoxicillin possess antimicrobial activity against major pathogens in orofacial odontogenic infections, but β-lactamase production has restricted the effectiveness of amoxicillin against the resistant strains of Staphylococcus aureus, Bacteroides, Prevotella and Porphyromonas. For the management of orofacial infections, the use of amoxicillin/clavulanate and clindamycin is recommended because of stability against β-lactamases.
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  • 文章类型: Journal Article
    牙源性或上呼吸道起源的威胁生命的感染可能扩展到由下头和上子宫颈区域的筋膜平面形成的潜在空间。并发症包括气道阻塞,纵隔炎,坏死性筋膜炎,海绵窦血栓形成,脓毒症,胸腔脓胸,Lemierre综合征,脑脓肿,眼眶脓肿,骨髓炎。现代抗生素治疗大大降低了这些“空间感染”的发生率。然而,严重的发病率甚至死亡继续发生。本研究回顾了牙源性感染的并发症。所做的搜索是基于PubMed和谷歌学者,并进行了广泛的出版作品搜索。使用术语“牙源性感染,“\”并发症,“和”风险因素。\"
    Life-threatening infections of odontogenic or upper airway origin may extend to potential spaces formed by fascial planes of the lower head and upper cervical area. Complications include airway obstruction, mediastinitis, necrotizing fascitis, cavernous sinus thrombosis, sepsis, thoracic empyema, Lemierre\'s syndrome, cerebral abscess, orbital abscess, and osteomyelitis. The incidence of these \"space infections\" has been greatly reduced by modern antibiotic therapy. However, serious morbidity and even fatalities continue to occur. This study reviews complications of odontogenic infections. The search done was based on PubMed and Google Scholar, and an extensive published work search was undertaken. Advanced MEDLINE search was performed using the terms \"odontogenic infections,\" \"complications,\" and \"risk factors.\"
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  • 文章类型: Case Reports
    大西在1975年首次描述了颞下颌关节(TMJ)关节镜。随着它的广泛使用,出现了一系列并发症。我们描述了一名接受关节镜检查后出现咽旁肿胀的患者。需要延长插管至术后1小时。肿胀在6小时内完全消退,无需进一步干预。
    Ohnishi in 1975 first described temporomandibular joint (TMJ) arthroscopy. Along with its extensive use, a range of complications has emerged. We describe a patient who experienced parapharyngeal swelling after undergoing arthroscopy. Prolonged intubation up to 1 hour postoperatively was required. The swelling resolved completely over 6 h without further intervention.
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