perimaxillary cellulitis
Introduction
Introduction to pericardial cellulitis Periorbital cellulitis is an acute inflammation that occurs in the interfascial interstitial tissue around the jaw. There are masticatory muscles and facial muscles in the upper and lower jaws. Between these muscles, the muscles and jaws are filled with loose connective tissue, forming some potential gaps. Because of the difference in anatomy, each gap has its own specific name, such as the masseter muscle gap, submandibular space and so on. When the infection invades these parts, periorbital cellulitis or gap infection can occur. The treatment of the disease is divided into systemic therapy and topical therapy. Systemic treatment: mainly to improve the body condition, enhance the resistance, the use of antibacterial drugs (metidazole, spiramycin) to control infection. If the condition is serious, two or more antibacterial agents may be used in combination, if necessary, intravenously. According to the principle of dialectical treatment, traditional Chinese medicines such as Fuzheng Dexie, Qingrejiedu, Xiaozhong Sanyu can be given. Topical treatment: In the early stage of inflammation, local physiotherapy and external application of Chinese herbal medicine can be used to promote inflammation absorption. When the abscess is formed, the drainage should be cut in time. When incision is made, the incision should be in the part that is good for drainage, to avoid damage to important nerves, blood vessels, catheters and other important structures. The parts should be concealed and as close as possible to the skin lines. After acute inflammation control, further treatment is applied to the pathogenic teeth. basic knowledge The proportion of illness: 0.003% Susceptible people: no specific population Mode of infection: non-infectious Complications: jaw osteomyelitis jaw cyst
Cause
Causes of pericardial cellulitis
Common sources of infection in periarticular cellulitis are the following:
1. Odontogenic infection The most common cause of this disease is caused by the spread of odontogenic infections, such as wisdom tooth pericoronitis, periapical inflammation, etc., infection of teeth in different parts often cause cellulitis in different parts.
2. Local tissue infections such as submandibular lymphadenitis and facial cramps can cause periorbital cellulitis.
3. Concurrent infection after trauma.
Prevention
Periarticular cellulitis prevention
Timely treatment of pericoronitis such as pericoronitis and periapical periodontitis has positive significance for prevention. If it has been formed, it should be thoroughly treated in the acute phase to avoid becoming chronic.
Complication
Periarticular cellulitis complications Complications jaw osteomyelitis jaw cyst
If the treatment is not timely or improper treatment, it can spread to other gaps and even cause serious systemic complications.
Symptom
Periorbital cellulitis symptoms common symptoms molars closed tight dyspnea secondary infection tongue movement restricted pronounced blood pressure drop asphyxia dysphagia jaws are "fan"...
In addition to the general systemic and local manifestations of cellulitis, due to the anatomical features of each gap, there are still special clinical manifestations, which will be separately described.
(1) Underarm cellulitis (infraorbital infection)
Infection occurs under the eyelids, between the anterior wall of the maxilla and the facial expression muscles, mostly from odontogenic infections such as the maxillary canine (such as periapical inflammation), but also from the upper lip or nasal side.
Local manifestations include redness and swelling in the infraorbital area, pain, difficulty in blinking the lower eyelid edema, swelling of the upper lip, disappearance of the nasolabial fold, and swelling of the anterior sulcus of the maxillary anterior teeth. The pathogenic teeth can often be found.
(B) under the masseter muscle cellulitis (the masseter muscle gap infection)
The infection occurs between the lateral wall of the mandible and the masseter muscle, mainly from the periapical infection of the mandibular pericardium and the mandibular molar, which is more common in periarticular cellulitis.
The main clinical features are the swelling and pain of the masseter muscle of the masseter muscle centered on the following jaw angle; the masseter muscle is in a paralyzed state due to inflammatory irritation, causing local hardening, limited mouth opening and even closed jaw; even if the abscess has formed, early fluctuations It is not obvious, and it is not easy to wear it by itself. Therefore, the drainage should be cut in time. If it is not sure whether the abscess is mature, the puncture can help the diagnosis. If the treatment is delayed, the drainage can not be cut in time, resulting in the spread of the infection, which may cause the mandible. osteomyelitis.
(three) submandibular cellulitis (submandibular space infection)
Clinically, the infection occurs in the submandibular triangle, mostly from the infection of the mandibular molar, and can also be caused by submandibular lymphadenitis, the latter especially seen in children.
Local manifestations include redness and swelling of the submandibular area, pain, loss of skin lines, shiny skin, lower jaw edge due to swelling, and severe submandibular cellulitis can spread to adjacent gaps or neck.
(4) Bottom cellulitis
Bottom cellulitis can be caused by infection of the lower jaw, acute tonsillitis, acute mandibular osteomyelitis or secondary infection of the oral cavity. Although this disease is rare, it is one of the serious infections of the oral and maxillofacial region. There are multiple gaps at the bottom of the mouth, which are clinically divided into purulent and spoiled necrosis, and the latter is more serious.
Inflammation usually begins in one side of the sublingual or submandibular area, and then rapidly spreads to the underarm and the contralateral side. When the inflammation spreads to the interstitial space, the bilateral submandibular and infraorbital areas and even the upper neck are extensively swollen. Yang, mouth half, mouth can be seen swelling in the mouth, tongue lift, tongue movement is limited, the patient's language, difficulty swallowing, such as swelling spread to the base of the tongue, can oppress the throat, epiglottis and cause breathing difficulties and even suffocation.
Corrosive necrotizing cellulitis at the mouth is mainly caused by anaerobic, spoilage and necrotic bacteria, rapid development of the disease, severe systemic poisoning, weak pulse, shortness of breath, severe body temperature rise, blood pressure drop, local swelling , hard, dark red skin, palpation can have pronunciation.
Examine
Examination of pericardial cellulitis
Detailed medical history, physical examination, blood test, parallel puncture and other examinations.
Diagnosis
Diagnosis and diagnosis of pericardial cellulitis
Differential diagnosis
Clinical manifestations of wisdom tooth pericoronitis
1. In the early stage of acute pericoronitis, there is no obvious systemic reaction. The patient feels painful and uncomfortable in the affected area. The chewing, swallowing, and pain in the mouth opening activity are intensified. The swelling of the affected teeth and the posterior molar area can be seen. There is a pus in the crown pocket. Sex secretions.
2. The inflammation develops further, involving the masseter muscle and the pterygoid muscle. The mandibular angle area is swollen, with varying degrees of mouth opening and even opening. The systemic symptoms are obvious, and there are often submandibular lymph nodes and tenderness. Can develop into periorbital abscess, maxillofacial cellulitis and even osteomyelitis.
3. Chronic pericoronitis can form a fistula on the buccal side of the mandibular first molar, or form a skin fistula at the anterior edge of the masseter muscle.
The main symptoms of acute wisdom tooth pericoronitis are swelling and pain of soft tissue around the crown. For example, inflammation affects the masticatory muscles, which may cause different degrees of mouth opening. If swallowing, the swallowing pain may occur, causing the patient to chew, eating and swallowing difficulties. In severe cases, there may be general symptoms such as general discomfort, headache, rising body temperature and loss of appetite.
