Buccal space infections

Background

• Cellulitis or abscess in buccal space
  • Space between buccinator and superficial fascia/skin
• Odontogenic source
  • Maxillary second and third molars most common

Diagnosis

• Ovoid cheek swelling with odontogenic disease
• CT not always necessary, but can define abscess
• Differential
  • Parapharyngeal space infxn
    • Swelling of neck and jaw angle,dysphagia,drooling,trismus,nuchal rig
  • Parotitis, bacterial or mumps
  • Neoplasm
  • Trauma
  • Facial cellulitis
  • Canine space infection from infected maxillary canine
    • Suggested by loss of nasolabial fold

Treatment

• Parenteral Abx coveral oral flora
  • Clindamycin,PCN V,third gen cephalosporin
• OMFS consult for abscess drainage,if present,and tooth extraction

Disposition

• OMFS/ENT consult
• Admit diabetics,immunocompompromised, discuss others with consultant

See Also

• Salivary Gland Infections

Source

• ER Atlas
• Rosen