An unusual abscess formation in the masticator space after acupressure massage: a case report

Abstract

Clinical features of masticator-space abscess (MSA) are very similar to those of parotitis or temporomandibular disorder (TMD), making early differential diagnosis difficult. Local causes of MSA include nerve block anesthesia, infection after tooth extraction, and trauma to the temporomandibular joint (TMJ); the systemic cause is immunodeficiency. Odontogenic causes account for most etiologies, but there are also unusual causes of MSA. A 66-year-old male patient visited the emergency room (ER) presenting with left-side TMJ pain three days after receiving an acupressure massage. He was tentatively diagnosed with conventional post-trauma TMD and discharged with medication. However, the patient returned to the ER with increased pain. At this time, his TMD diagnosis was confirmed. He made a third visit to the ER during which facial computed tomographic (CT) images were taken. CT readings identified an abscess or hematoma in the left masticator space. After hospitalizing the patient, needle aspiration confirmed pus in the infratemporal and temporal fossa. Antibiotics were administered, and the abscess was drained through an incision made by the attending physician. The patient's symptoms decreased, and he was discharged.

The Result of Treatment of Deep Neck Infection in Patients Referred According to Public Health System

“…Patients with masticator space abscesses were different in both groups, as most masticator space abscesses were caused by the degree dental care. 23 This group of patients had the same characteristics as patients with care, including masticator space abscess patients who could not open their mouths. This was a serious concern of the patients.…”

An Unusual Masticator Space Infection Initially Presenting as Temporomandibular Joint Dislocation: A Case Report

“…Ko et al reported a case with abscess formation in the masticator space after acupressure massage, which was initially diagnosed as TMD. After CT imaging and needle aspiration, the treatment focused on MSI and the patient's symptoms improved [4]. Matsumura et al also presented a case with peritemporomandibular abscess as a complication of acupuncture [7].…”

“…The masticator space, a collective term for the superficial and deep temporal, submasseteric, and pterygomandibular spaces, is confined by the masticator muscles including the temporalis, masseter, lateral, and medial pterygoid muscles [4]. Masticator space infection (MSI), which is mostly caused by the spread of odontogenic infection, may present as TMJ pain, masticator muscle tenderness, or trismus.…”

“…Masticator space infection (MSI), which is mostly caused by the spread of odontogenic infection, may present as TMJ pain, masticator muscle tenderness, or trismus. Without obvious dental infection, MSI can easily be misdiagnosed as TMJ disorder (TMD) [4,5].…”

Untitled

“…1 Knowledge of precise localization of purulent content is crucial for decisions regarding surgical intervention. 1 There is a bunch of literary sources [2][3][4][5] which describe diverse aspects of diagnostics and management of purulent head and neck conditions, but not enough number of articles [6][7][8] , presenting a profound description of ultrasound (US) images in those patients. And even many fewer studies focus on ultrasound upon infection of masticatory space.…”