Title : Odontogenic infection of the infratemporal fossa: A rarity and diagnostic challenge
Abstract:
The infratemporal fossa (IF) is an important anatomical space that carries vital neurovascular structures within it. The formation of an abscess in the IF, particularly of odontogenic aetiology, is rare. It can pose a diagnostic challenge due its uncommon presentation and can be life-threatening with delayed treatment.
The IF is a wedge-shaped space bounded laterally by the ramus of mandible, medially by lateral pterygoid plate and superiorly by the greater wing of sphenoid bone. Its contents include the muscles of mastication, the pterygoid venous plexus and several nerves including the mandibular and lingual nerves.
IF abscesses can develop from odontogenic or sino-nasal infections. Odontogenic source of IF abscesses are rare as they usually spread through buccal, submandibular or sublingual spaces (or a combination of these). The pathological implications related to spreading infection into IF is closely related to the anatomy involved. It is therefore essential clinicians have good knowledge of the anatomy of the facial spaces to be able to promptly recognise the presentation and manage them urgently.
We present a report of an unusual case of IF abscess of odontogenic source in an otherwise healthy female patient which was initially misdiagnosed. With the rising difficulty accessing emergency NHS dental services in the UK, the untimely delayed diagnosis and management of odontogenic infections may lead to similar scenarios such as this.
Audience Take Away:
- It is important that clinicians have an understanding of the presentation and spread of odontogenic infections and the sequelae of such
- Be aware of the clinical significance of the infratemporal fossa in that odontogenic infection can spread to it, spreading posteriorly due to bony barriers present anterior, medial and posterior in the fossa.
- The presentation discusses the anatomy of spread of infections
- Clinicians can develop confidence referring or managing similar cases in a timely and appropriate manner
