Fascial spaces

summary of fascial spaces within the head and neck region

1. FASCIAL SPACES PRESENTED BY: EMMANUEL LANG’AT MOI UNIVERSITY BDS 3 RD YEAR STUDENT

2. FASCIAL SPACES Fascial space is a portion of anatomy that is partially or completely walled by fascial membrane ( fascial layers). Fascial area are potential areas between layers of fascia. Fascial space areas are filled normally with loose connective tissue which readily breakdown when invaded by infection, leading to a large swelling. Fascial space infections are the most common cause of swellings in the head and neck region. There are 16 fascial spaces of the head and neck region.

3. Fascial Layers Divided into : Superficial fascia Deep fascia

4. Superficial fascia This fascia lies just under the skin, as it does in the entire body, invests the superficially situated mimetic muscles ( platysma , orbicularis oculi, and zygomaticus major and minor), and is located in distinct anatomic areas. It is composed of 2 layers, an outer fatty layer and a thin inner membrane with a large number of elastic fibers. The superficial fascia attaches the skin to the deep fascia, which covers and invests the structures lying deep to the skin while maintaining the movability of the skin, with the two layers allowing for separation during blunt dissection.

5. Deep fascia The deep fascia begins at the anterior border of the masseter muscle, attaches to the superior temporal and nuchal lines, and posterior and inferior to these margins it continues cranially as the pericranium . The (1) deep facial fascia represents a continuation of the (2) deep cervical fascia cephalad into the face and, more posterior, invests the muscles of mastication. The surgical importance lies in the fact that the facial nerve branches within the cheek lying deep to this fascial layer.

6. Classification of fascial spaces F ascial spaces of the face: Canine Buccal Infratemporal Parotid M asticatory spaces - Massetric spaces, P terygomandibular space, Temporal space ( Z ygomaticotemporal space)

7. Classification of fascial spaces Suprahyoid fascial spaces : Sublingual space Submental space Submandibular space Lateral pharyngeal space Peritonsillar space

8. Classification of facial spaces Infrahyoid fascial spaces: Pretracheal Fascial spaces of the neck: Retropharyngeal space Danger space Carotid sheath space

9. Routes for spread of infection from dentoalveolar infections Upper lip Canine fossa Infraorbital region Buccal space (5) Palate Submasseteric space (3) Retropharyngeal Lateral pharyngeal (1) Pterygomandibibular space (2) Infratemporal fossa Parotid space Buccinator space (4) Suprahyoid region – submandibular space, submental space, sublingual space.

10. Direction of spread of infection, and the fascial spaces involved, from the lower third molar site.