Fascial space odontogenic infections: Ultrasonography as an alternative to magnetic resonance imaging

Abstract

BACKGROUND The introduction of modern diagnostic tools has transformed the field of maxillofacial radiology. Odontogenic infection and fascial space involvement have been evaluated with many diagnostic tools, including ultrasonography (USG) and magnetic resonance imaging (MRI). AIM To explore USG as an alternative model to MRI in the detection of fascial space spread of odontogenic infections. METHODS Among 20 patients, 50 fascial spaces were clinically diagnosed with odontogenic infection and included in this prospective study. Fascial space infection involvement was examined by USG and MRI. Results were compared for both and confirmed by microbiological testing. RESULTS Ultrasonography identified 42 (84%) of 50 involved fascial spaces. Whereas MRI identified all 50 (100%). USG could stage the infections from edematous change to cellulitis to complete abscess formation. CONCLUSION MRI was superior in recognizing deep fascial space infections compared to USG. However, USG is a significant addition and has a definite role in prognosticating the stage of infection and exact anatomic location in superficial space infections.

Indicadores clínicos e laboratoriais como determinantes de um padrão na evolução das infecções orais graves - Estudo retrospectivo de 3 anos

“…Semelhante ao espaço mastigatório, o envolvimento do espaço submandibular leva a sintomas graves como trismo, rigidez do pescoço, desconforto respiratório, disfagia, sialorreia e disfonia. Em relação ao envolvimento do espaço facial, encontramos que 65% dos pacientes apresentavam infecção de dois ou mais espaços contra 47% da literatura, 35% dos pacientes apresentaram infecções de espaço único, enquanto a literatura cita uma média de 53% para infecções de um único espaço (Bali, R. K. et al, 2015;Ghali et al, 2021;Yang et al, 2015).…”

Should preoperative computed tomography be routine examination for cervicofacial space infections?

“…According to the study by Babu et al [ 23 ], CT was superior to MRI in the aspects of detection of intralesional gas and calcium and motion artifacts. The drawbacks of MRI are obvious as being time-consuming, expensive, and not readily available, making it impractical for most typical cervicofacial space infections [ 23 , 25 ].…”

“…They conducted a study on 50 patients with superficial fascial spaces, in which US helped in identifying abscesses in 22 patients and cellulitis in 28 patients. However, US could not accurately detect those infections involving deep fascial spaces [ 25 , 27 ], thereby limiting its use in cervicofacial space infections. The study by Kalmovich et al [ 24 ] reported that ultrasound did not correlate well with the presence of parapharengeal abscess.…”

Orofacial fascial space abscess disguised as temporomandibular disorder: a report of 3 cases and literature review

“…Other possible sources of infection include trauma, sinus disease, and invasive treatment of the orofacial area [ 3 ]. Common symptoms of fascial space infection and abscess in the orofacial area include limited mouth opening, neck stiffness, dyspnea, dysphagia, fever, swelling and redness [ 4 ]. If the diagnosis and treatments of fascial space abscess in the orofacial area are delayed, the abscess can spread into more critical structures including neck, airway, orbital septum, and even brain, leading to grave consequences [ 5 , 6 ].…”