Computed tomographic findings in two cases of cellulitis of the infratemporal fossa with abscess formation

Infratemporal fossa infection with inferior alveolar nerve involvement

Abscess of the infratemporal fossa is a rare complication which can be difficult to diagnose. It occurs mostly due to dental infection, tooth extraction, fractures and/or infections involving the maxillary sinus. This condition can be life threatening if not dealt with immediately. The maxillofacial surgeon must be aware of the symptoms and clinical findings of the infection of the infratemporal fossa in order to initiate the treatment as soon as possible. In this case report, a patient with an infratemporal fossa infection presenting with an unusual symptom of inferior alveolar nerve involvement is presented.

Minimally invasive transnasal approach to infratemporal fossa abscess

Background:

Infratemporal fossa abscess following odontogenic infection is not rare, and usually occurs as a sequela of dental disease. Infratemporal fossa abscess was previously treated with the combination of buccal incision and temporal incision, or via a transoral approach.

Method:

This paper reports a case of infratemporal fossa abscess in a 51-year-old female.

Results:

The abscess was drained transnasally via an endoscopic modified medial maxillectomy approach, preserving the inferior turbinate and nasolacrimal duct. The pain remitted the next day and trismus had diminished in one week.

Conclusion:

The transnasal approach with endoscopic modified medial maxillectomy is a direct, minimally invasive method that provides a direct field of view for drainage of infratemporal fossa abscess. This approach is recommended for infratemporal fossa abscess.

Endoscopic transmaxillary drainage of an infratemporal fossa abscess

Infratemporal fossa abscess is a rare and challenging condition to diagnose and manage. A few reported cases have been mostly due to odontogenic infections and were managed by external or intraoral drainage. This is the first reported case of an infratemporal fossa abscess that was successfully managed by endoscopic drainage via a transmaxillary approach.

Infratemporal space infection following maxillary third molar extraction in an uncontrolled diabetic patient

Infratemporal space infection is a rare but serious sequel of odontogenic infection. The diagnosis is difficult due to non spe-cific signs and symptoms. Diabetes mellitus as a definitive risk factor for odontogenic infections needs more consideration during clinical procedures. We report a case of an undiagnosed diabetic patient with isolated infratemporal space infection after tooth extraction with presentation of similar signs and symptoms of temporomandibular joint and muscle problem.

Subacute infratemporal fossa cellulitis with subsequent abscess formation in an immunocompromised patient

OBJECTIVES

To present a case of subacute infratemporal fossa cellulitis with subsequent abscess formation to show important anatomic relationships as they effect presentation and treatment of infections in this area.

STUDY DESIGN

Case report and brief literature review.

METHODS

The case of an immunocompromised patient who developed subacute infratemporal fossa cellulitis with subsequent abscess formation is presented. A literature review discusses etiology, diagnosis, and treatment of these infections.

RESULTS

Careful history and physical examination revealed unilateral facial pain, swelling, and trismus to be caused by an infratemporal fossa abscess. Intraoral drainage and intravenous antibiotic therapy led to resolution of the infection.

CONCLUSION

Infratemporal fossa abscesses are potentially dangerous complications of odontogenic infections. Although clinical diagnosis may be difficult, knowledge of relevant anatomy and pathways of spread allow more effective diagnosis and treatment of these infections.

Infratemporal and submasseteric infection following extraction of a non-infected maxillary third molar

A case is described where an otherwise fit young female patient developed a large submasseteric abscess following the uneventful extraction of a non-infected maxillary third molar under local anaesthesia with intravenous sedation. This report highlights the difficulty of clinical diagnosis especially in the early stages of the infection. This case also demonstrates the imaging modalities used to confirm the diagnosis. It is likely that the infection in this case arose in an infratemporal fossa haematoma resulting from reactionary haemorrhage. Careful injection of local anaesthetic with aspiration may prevent this complication arising. This is the first reported case of a submasseteric abscess associated with the extraction of a clinically non-infected maxillary third molar.