1
|
Kim CY, Takeshita Y, Kugimoto T, Harada H, Park JS, Tubbs RS, Iwanaga J. Anatomy of the Buccal Space: Surgical and Radiological Perspectives. J Craniofac Surg 2024:00001665-990000000-01720. [PMID: 38885157 DOI: 10.1097/scs.0000000000010411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 05/18/2024] [Indexed: 06/20/2024] Open
Abstract
Among the anatomical spaces in the head and neck area, the buccal space has often been studied in dental/oral surgery and cosmetic surgery because it contains the facial vessels, mandibular and facial nerves, and adipose tissue called the buccal fat pad. In addition, as the space can communicate with other spaces, it can be significant in infections. Although the anatomy of the buccal space has been reported in several studies, there have been discrepancies concerning its boundaries, and its communications have often been overlooked. The aim of this review is to examine the anatomy of buccal space including its boundaries, contents, continuity with adjacent spaces, and clinical significance. A literature review was performed on Google Scholar and PubMed. The literature has depicted the anterior, medial, and lateral boundaries more or less consistently, but descriptions of the posterior, superior, and inferior borders are controversial. The buccal space includes the facial arteries, veins, facial nerves, parotid duct, and lymph nodes, which can be described differently depending on definitions and the extent of the space. As it communicates with other anatomical spaces including the masticatory space, it can be a reservoir and a channel for infections and tumors. Buccal fat pads have various clinical applications, from a candidate for flap reconstruction to a target for removal for cosmetic purposes. This review will help understand the anatomy of the buccal space including its boundaries, residing structures, and communication with other spaces from surgical and radiological perspectives.
Collapse
Affiliation(s)
- Chung Yoh Kim
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA
| | - Yohei Takeshita
- Department of Oral and Maxillofacial Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama
| | - Takuma Kugimoto
- Department of Oral and Maxillofacial Surgical Oncology, Division of Oral Health Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroyuki Harada
- Department of Oral and Maxillofacial Surgical Oncology, Division of Oral Health Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Jin Seo Park
- Department of Anatomy, Dongguk University School of Medicine, Gyeongju, Republic of Korea
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA
- Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine
- Department of Structural and Cellular Biology, Tulane University School of Medicine
- Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada
- Department of Surgery, Tulane University School of Medicine, New Orleans, LA
- University of Queensland, Brisbane, Australia
| | - Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA
- Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine
- Department of Structural and Cellular Biology, Tulane University School of Medicine
- Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA
- Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Dental and Oral Medical Center, Kurume University School of Medicine, Asahi-machi, Kurume, Fukuoka, Japan
- Department of Anatomy, Division of Gross and Clinical Anatomy, Kurume University School of Medicine, Asahi-machi, Kurume, Fukuoka, Japan
| |
Collapse
|
2
|
Qiao Z, Zou Y, Liu S, Zhao H, Li X. Antineutrophil cytoplasmic antibody‑associated vasculitis complicated with oral and maxillofacial space infection in a young woman: A case report. Exp Ther Med 2023; 26:344. [PMID: 37383370 PMCID: PMC10294597 DOI: 10.3892/etm.2023.12043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 04/27/2023] [Indexed: 06/30/2023] Open
Abstract
Antibody-associated vasculitis (AAV) is a systemic autoimmune disease, with hormones and immunosuppressants as its main treatment measures. However, during the treatment process, various infections such as lung infections and urinary tract infections are prone to occur, and patients with OMSI are relatively rare. The present case report describes the case of a young woman who received long-term oral glucocorticoids and immunosuppressive agents for the treatment of antineutrophil cytoplasmic (AAV). At hospital admission, the patient with a high fever and painful swelling of the left side of the mouth. The patient was diagnosed with an oral and maxillofacial space infection (OMSI). Therefore, the local incision, drainage and irrigation of abscesses were subsequently performed. Additionally, the immunosuppressive agents were discontinued, the glucocorticoid dose was reduced and intravenous antibiotic therapy was provided. The patient was discharged 1 week later in good condition. Notably, the incidence of AAV is extremely low. Although OMSI is not uncommon, the simultaneous occurrence of AAV in combination with OMSI has not been reported previously. To the best of our knowledge, this is the first reported case of AAV combined with OMSI.
Collapse
Affiliation(s)
- Zhu Qiao
- Department of Stomatology II, Baoding No. 1 Central Hospital of Hebei Medical University, Baoding, Hebei 071000, P.R. China
| | - Yue Zou
- Central Sterile Supply Department, Baoding No. 1 Central Hospital of Hebei Medical University, Baoding, Hebei 071000, P.R. China
| | - Shuangyan Liu
- Department of Internal Medicine, Graduate School of Hebei Medical University, Shijiazhuang, Hebei 050011, P.R. China
| | - Hu Zhao
- Department of Stomatology II, Baoding No. 1 Central Hospital of Hebei Medical University, Baoding, Hebei 071000, P.R. China
| | - Xiaodong Li
- Department of Nephrology, Baoding No. 1 Central Hospital of Hebei Medical University, Baoding, Hebei 071000, P.R. China
| |
Collapse
|
3
|
Song YK, Jo DH. Current and potential use of fresh frozen cadaver in surgical training and anatomical education. ANATOMICAL SCIENCES EDUCATION 2022; 15:957-969. [PMID: 34538016 DOI: 10.1002/ase.2138] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 09/15/2021] [Accepted: 09/15/2021] [Indexed: 05/22/2023]
Abstract
As surgical procedures continue to be more complex, the need for more effective training in anatomy has increased. The study of anatomy plays a significant role in the understanding of the human body as well as in basic and advanced clinical training. Among the different cadaver models, fresh frozen cadavers (FFCs) are known for their realistic tissue quality. The purpose of this article was to review and summarize the preparation procedures for and reported cases involving FFCs. PubMed, Scopus, Medline, and Web of Science were searched for relevant studies. The preparation procedures were divided into five steps: washing, irrigation, freezing, defrosting, and arterial infusion. Not all steps were reported to be mandatory, but omitting one or more could result in a loss of quality. FFCs were reported to be used for various purposes: undergraduate education, general surgery training, vascular surgery training, minimal access surgery (laparoscopic surgery) training, and microsurgery training. In all categories, expert opinions and statistical analyses indicated successful outcomes. The reasons for high satisfaction with FFCs included realistic texture, capability of reenacting actual operations, and accuracy of anatomical locations. The results also revealed the importance and advantages of the dissection courses in surgical training. Since the direct comparison between cadaver models is insufficient, future studies regarding this topic are deemed necessary. In addition, it would be advantageous to develop methods to improve FFC quality, or ideas to optimize this model for certain purposes.
Collapse
Affiliation(s)
- Yong Keun Song
- Department of Preliminary Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Dong Hyun Jo
- Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
4
|
Amin M, Jama GM, Ahmed U, Horsburgh A, Hassaan A. Complicated peritonsillar abscess extending into the buccal space: an unusual clinical presentation. Br J Hosp Med (Lond) 2022; 83:1-3. [DOI: 10.12968/hmed.2021.0591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Mohamed Amin
- Department of Otolaryngology, Queen's Hospital, Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - Guled M Jama
- Department of Otolaryngology, Queen's Hospital, Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - Usama Ahmed
- Department of Otolaryngology, Queen's Hospital, Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - Avril Horsburgh
- Department of Radiology, Queen's Hospital, Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - Amro Hassaan
- Department of Otolaryngology, Queen's Hospital, Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| |
Collapse
|
5
|
Masui M, Ibaragi S, Takeshita Y, Iwanaga J, Kunisada Y, Sasaki A. Displacement of lower third molar into floor of mouth: a single institutional experience. Oral Maxillofac Surg 2021; 26:447-453. [PMID: 34596806 DOI: 10.1007/s10006-021-01012-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 09/23/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE The displacement of the tooth/tooth fragment into the floor of mouth sometimes happens during the lower third molar surgery and the patients are usually referred to oral and maxillofacial surgeons. To date, however, there is no consensus how to manage the displaced tooth due to the lack of available data. METHODS In this study, we have retrospectively analyzed the management of the displaced lower third molar into the floor of mouth. Our institute experienced seven cases during 2010 to 2020. RESULTS Incidence rate of the lingual nerve injury caused by displacement of the lower third molar was 1/7. Six patients out of seven underwent surgical removal of the displaced fragment. The direct approach was used when the fragment was palpable superficially and the fragment was horizontally located away from the lingual plate (2 cases), while when the fragment was not palpable, or was palpable and adjacent to the lingual plate, the lingual mucoperiosteal flap was selected (4 cases). CONCLUSION We conclude that the palpation and preoperative diagnosis with computed tomographic images are significantly important to decide a better and most effective surgical approach.
Collapse
Affiliation(s)
- Masanori Masui
- Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1Shikata-cho, Kita-ku, Okayama-shi, 700-8525, Japan
| | - Soichiro Ibaragi
- Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1Shikata-cho, Kita-ku, Okayama-shi, 700-8525, Japan.
| | - Yohei Takeshita
- Department of Oral and Maxillofacial Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1Shikata-cho, Kita-ku, Okayama-shi, 700-8525, Japan
| | - Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Japan
| | - Yuki Kunisada
- Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1Shikata-cho, Kita-ku, Okayama-shi, 700-8525, Japan
| | - Akira Sasaki
- Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1Shikata-cho, Kita-ku, Okayama-shi, 700-8525, Japan
| |
Collapse
|
6
|
Iwanaga J, Yilmaz E, Loukas M, Xu L, Uz A, Walocha JA, Dumont AS, Tubbs RS. An anatomical study of the pharyngeal plexus: Application to avoiding postoperative dysphagia following anterior approaches to the cervical spine. Clin Anat 2021; 35:264-268. [PMID: 34535923 DOI: 10.1002/ca.23785] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 09/07/2021] [Indexed: 11/12/2022]
Abstract
We aimed to localize the pharyngeal branches of the pharyngeal plexus to preclude postoperative complications such as dysphagia resulting from injury to those branches. Cranial nerves IX and X and the sympathetic trunk were dissected on 10 sides in the necks of embalmed adult cadavers of European descent to identify the pharyngeal branches so that anatomical landmarks could be identified and injury thereby avoided. In all sides, the pharyngeal branches originated from the glossopharyngeal and vagus nerves and the superior cervical ganglion and entered the posterior pharyngeal wall at the C2-C4 levels within 10 mm medial to the greater horn of the hyoid bone. All pharyngeal branches were anterior to the alar fascia. Based on our anatomical study, vagus nerve branches to the pharyngeal muscles enter at the C3/C4 vertebral levels. Such knowledge might help decrease or allow surgeons to predict which patients are more likely to develop dysphagia after cervical spine surgery.
Collapse
Affiliation(s)
- Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Japan.,Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Japan
| | - Emre Yilmaz
- Department of Trauma Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - Marios Loukas
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada
| | - Lu Xu
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Aysun Uz
- Anatomy, Faculty of Medicine, University of Ankara, Ankara, Turkey.,Department of Neuroscience, Ankara University Graduate School of Health Science, Ankara University School of Medicine, Ankara, Turkey
| | - Jerzy A Walocha
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Aaron S Dumont
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Department of Anatomical Sciences, St. George's University, St. George's, Grenada.,Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, Louisiana, USA.,University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
7
|
Lombardi D, Ferrari M, Paderno A, Taboni S, Rampinelli V, Barbara F, Schreiber A, Mattavelli D, Tomasoni M, Farina D, Ravanelli M, Maroldi R, Nicolai P. Selection of the surgical approach for lesions with parapharyngeal space involvement: A single-center experience on 153 cases. Oral Oncol 2020; 109:104872. [PMID: 32659725 DOI: 10.1016/j.oraloncology.2020.104872] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND The parapharyngeal space (PPS) can harbor a variety of tumors that can be approached through a wide spectrum of surgical routes. A decisional algorithm on the surgical approach to resect PPS lesions was tested in terms of reliability by retrospectively applying it to a large series of patients. METHODS Patients treated at the Unit of Otorhinolaryngology - Head and Neck Surgery of the University of Brescia, Italy, for tumor or tumor-like lesions involving the PPS between October 1986 and July 2019 were included in the retrospective analysis. Tumor characteristics, clinical presentation, diagnostic work-up, type of resection, surgical approach, and oncologic and morbidity outcomes were reviewed. Reliability of the algorithm was calculated as the number of cases in which the expected approach was confirmed/total number of cases × 100. RESULTS The analysis included 153 patients. Most lesions (64.1%) were benign. The most frequent complaint at presentation was unilateral oropharyngeal medialization (47.1%), followed by neck/parotid swelling (41.2%). Ninety-two (61.3%) lesions were excised through an enucleation/extracapsular dissection. Wide-margin resection and compartmental resection were performed in 17 (11.3%) and 41 (27.3%) patients, respectively. A single-corridor approach was employed in 132 (87.4%) cases. Combinations of multiple corridors were adopted in 19 (12.6%) patients. Reliability of the decision-making algorithm was 91.2%. Capsular integrity and margin status affected prognosis of pleomorphic adenomas and PPS malignancies, respectively. CONCLUSION The proposed decision-making algorithm can reliably guide approach selection, which should primarily aim at ensuring intact-capsule excision of benign lesions suspicious for pleomorphic adenomas and clear-margins resection of PPS malignancies.
Collapse
Affiliation(s)
- Davide Lombardi
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, University of Brescia, Brescia, Italy.
| | - Marco Ferrari
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, University of Brescia, Brescia, Italy; Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy
| | - Alberto Paderno
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Stefano Taboni
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Vittorio Rampinelli
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Francesco Barbara
- Unit of Otolaryngology and Head and Neck, P.O. "Mons. R. Dimiccoli", Barletta, Italy
| | - Alberto Schreiber
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Davide Mattavelli
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Michele Tomasoni
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Davide Farina
- Unit of Radiology, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Marco Ravanelli
- Unit of Radiology, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Roberto Maroldi
- Unit of Radiology, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Piero Nicolai
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy
| |
Collapse
|