This document discusses the anatomy of the facial spaces and fascia of the head and neck region. It defines fascia as sheets of dense connective tissue that separate structures. The facial spaces are potential spaces within the layers of fascia that can become infected. It then describes the various layers of fascia, including the superficial fascia and three layers of deep cervical fascia. It also lists the main muscles of the face and neck along with their origins, insertions and blood supply.

1. SPACES OF HEAD AND NECK

2. INTRODUCTION
ANATOMY
DEFINITION
FASCIA
CLASSIFICATION OF SPACES
CONCLUSION

3.  THE INFECTION IN OROFACIAL REGION DOES
NOT SPREAD HAPHAZARDLY THROUGH THE
LOOSE CONNECTIVE TISSUE, BUT TENDS TO
ACCUMULATE IN THESE POTENTIAL SPACES
AROUND THE HEAD AND NECK. MANY OF
THESE SPACES COMMUNICATE WITH EACH
OTHER.

4. THE CONCEPT OF FASCIAL
“SPACES” IS BASED ON
ANATOMIST’S KNOWLEDGE THAT
ALL “SPACES” EXIST POTENTIALLY,
UNTIL FASCIAE ARE SEPARATED BY
PUS, BLOOD, DRAINS OR SURGEONS
FINGER.

5. WHEN DENTAL INFECTIONS SPREAD
DEEPLY INTO SOFT TISSUE RATHER
THAN EXITING THROUGH ORAL OR
CUTANEOUS ROUTES,FASCIAL SPACES
MAY BECOME INVOLVED FOLLOWING
PATH OF LEAST RESISTANCE.

6.  Facial muscles are subcutaneous muscles
 Embryologically ,they develop from the
mesoderm of the second brachial arch
,therfore supplied by facial nerve
 Morphologically ,they represents the best
remnants of panniculus carnosus,a
continuous muscle sheet seen in some
animals

7.  SUPRAMANDIBULAR
 INFRAMANDIBULAR
 INFRAHYOID
 NECK
 MOUTH AND NOSE
 EYELIDS AND EYEBRO
 SCALP

8.  MASSETER
 TEMPORALIS
 MEDIAL PTERYGOID
 LATERAL PTERYGOID

9. MASSETER
SUPERFICIAL , MIDDLE,DEEP-ANT2/3RD,POST1/3RD,DEEP SURFACE
OF ZYGOMATIC ARCH
-SUPERFICIAL,MIDDLE,DEEP LAYER
RAMUS+CORONOID PROCESS
=2ND PART OF MAXILLARY ARTERY

10. TEMPORALIS
-TEMPORAL FOSSA AND FASCIA
-CORONOID PROCESS AND RAMUS OF MANDIBLE
=2ND PART OF MAXILLARY ARTERY

11. MEDIAL PTERYGOID
-SUPERFICIAL-MAXILLARY TUBEROSITY
-DEEP-MED SURFACE OF LATERAL PTERYGOID
TO ANGLE AND ADJOINING RAMUS OF MANDIBLE
=2ND PART OF MAXILLARY ARTERY

12. LATERAL PTERYGOID
-UPPER -INFRATEMPORAL SURFACE +CREST OF GREATER WING OF
SPHENOID
TO PTERYGOID FOVEA OF NECK OF MANDIBLE
-LOWER-LAT SURFACE OF LATERAL PTERYGOID PLATE
TO ARTICULAR DISC AND CAPSULE OF TMJ
=2ND PART OF MAXILLARY ARTERY

13.  DIGASTRIC
 GENIOHYOID
 MYLOHYOID
 STYLOHYOID

14. DIGASTRIC
-ANTERIOR BELLY-DIGASTRIC FOSSA OF MANDIBLE
-POST BELLY-MASTOID NOTCH OF TEMPORAL BONE
TO HYOID BONE BY A FIBROUS PULLEY
-ant-facial artery, post-occipital artery

15. GENIOHYOID
-INF MENTAL SPINE(GENIAL TUBERCLE)
TO ANT SURFACE OF BODY OF HYOID
-hyoid branch of lingual artery

16. MYLOHYOID
-MYLOHYOID LINE OF MANDIBLE
TO BODY OF HYOID
-hyoid branch of lingual artery

17. STYLOHYOID
-POSTERIOR SURFACE OF STYLOHYOID
TO JUNCTION OF BODY AND GREATER CORNU OF HYOID
-hyoid branch of lingual artery

18.  STERNOHYOID
 OMOHYOID
 STERNOTHYROID
 THYROHYOID

19. STERNOHYOID
-POST BORDER OF MANUBRIUM STERNI,CLAVICLE,POST
STERNOCLAVICULAR LIGAMENT
TO MEDIAL PART OF LOWER BORDER OF HYOID BONE
-hyoid branch of lingual artery

20. OMOHYOID
-UPPER BORDER OF SCAPULA NEAR SUPRASTERNAL
NOTCH,SUPRASCAPULAR LIGAMENT
TO LOWER BORDER OF BODY OF HYOID
-hyoid branch of lingual artery

21. STERNOTHYROID
-POST SURFACE OF MANUBRIUM STERNI,1ST COSTAL CARTILAGE
TO OBLIQUE LINE ON THE LAMINA OF THYROID CARTILAGE
-hyoid branch of lingual artery

22. THYROHYOID
-OBLIQUE LINE OF THYROID CARTILAGE
TO LOWER BORDER OF THE BODY AND GREATER CORNUA OF
THYROID CARTILAGE
-hyoid branch of lingual artery

23.  PLATYSMA
PLATYSMA
-UPPER PARTS OF PECTORAL
AND DELTOID FASCIAE
TO BASE OF MANDIBLE,SKIN OF
LOWER FACE AND LIP,CONTINUOUS
WITH RISORIUS
-BRANCHES OF SUBMENTAL
(FACIAL) AND SUPRASCAPULAR ARTERY
(THYROCERVICAL TRUNK- SUBCLAVIAN)

24.  COMPRESSOR NARIS (nasalis)
 DILATOR NARIS
 DEPRESSOR SEPTI

25. DILATOR NARIS
-from margin of nasal notch of maxilla and lesser alar cartilages
-to the skin near margin of nostril

26. DEPRESSOR SEPTI
-from incisive fossa of maxilla
-to the nasal septum

27. COMPRESSOR NARIS(NASALIS)
-alveolar eminences of lateral incisor and canine of upper jaw
at the base of alveolar process
-to the wing of the nose

28.  TRANSVERSUS MENTI
 LEVATOR LABII SUPERIORIS
 ZYGOMATICUS MAJOR & MINOR
 RISORIUS
 LEVATOR ANGULI ORIS
 DEPRESSOR ANGULI ORIS

29.  DEPRESSOR LABII INFERIORIS
 MENTALIS
 BUCCINATOR
 ORBICULARIS ORIS
 INCISIVUS

30. LEVATOR LABII SUPERIORIS
-angular head-from the frontal processs of the maxilla
-infraorbital head-below the infraorbital margin parallel to it to the zygomatic process
-zygomatic head-most prominent part of the zygomatic bone
-FACIAL ARTERY

31. ZYGOMATICUS MAJOR
-from temporal process of zygomatic bone
-to the corner of the mouth divided by the levator anguli oris into superficial & deep
head
-FACIAL ARTERY

32. RISORIUS
-from the fascia of the masseter muscle
-to the corner of the mouth
-FACIAL ARTERY

33. LEVATOR ANGULI ORIS
-from the canine fossa and passes downward and lateral
-divides the zygomatic major muscle
-FACIAL ARTERY

34. DEPRESSOR ANGULI ORIS
-outer surface and above the lower border of the mandible
-to the corner of the mouth
-FACIAL ARTERY

35. DEPRESSOR LABII INFERIORIS
-upward and medially to the lower lip
-FACIAL ARTERY

36. MENTALIS
-oval area in the depth of the mental fossa interlace with the muscle of the
opposite side of chin

37. BUCCINATOR
-alveolar process from 1st molar distally to the suture between maxilla and
palatine bone
- alveolar process from 1st molar till the lower end of retromolar fossa
-BUCCAL ARTERY (MAXILLARY ARTERY 2ND PART)

38. ORBICULARIS ORIS
-occupies the entire width of the lips with no direct attachment to the
skeleton
-upper and lower fibres crossing each other at the corner of the mouth

39.  ORBICULARIS OCULI
 DEPRESSOR SUPERCILII
 PROCERUS NASII
 CORRUGATOR SUPERCILII

40. DEPRESSOR SUPERCILII
-from lacrimal crest of frontal maxillary process
-skin of the head of the eyebrow
-OPHTHALMIC ARTERY

41. PROCERUS NASII
-from the nasal bone
-to the skin of the brow and of forehead in the glabellar region
between the eyebrows

42. CORRUGATOR SUPERCILII
-from frontal bone at the medial end of the superciliary arch
-to the outer part of the eyebrow and skin of forehead immed
above it
-OPHTHALMIC ARTERY

43.  FRONTALIS
 OCCIPITALIS

44. FRONTALIS
-from anterior border of galea aponeurotica
-to skin of eyebrow and root of nose
-OPHTHALMIC ARTERY

45. OCCIPITALIS
-Supreme nuchal line from base of mastoid process
-to the midline and into the fibres of the aponeurotic
cap
-OCCIPITAL ARTERY

46.  The face is supplied by branches of the
external carotid and the internal carotid
artery
 Two main branches of the external
carotid
Facial artery and superficial temporal
artery
Main branches of the internal carotid that
supplies the medial upper face and scalp is
the ophthalmic artery

48.  Most veins in the face run parallel with
their corresponding arteries
 These veins lack valves and therefore
allow bidirectional blood flow
 The facial vein can communicate with
the
cavernous sinus through the ophthalmic
vein or the pterygoid plexus (which drain
the paranasal area and the upper lip).
 Wound infections in this area have the
potential to gain access to the
cavernous sinus

50.  Motor supply
◦ Facial nerve

51.  Ophthalmic division
 Supratrochlear
 Supraorbital
 Lacrimal
 Infratrochlear
 External nasal
 Maxillary nerve
 Infraorbital
 Zygomaticofacial and
zygomaticotemporal
 Mandibular nerve
 Auriculotemporal
 Buccal nerve
 Mental
 Skin over the mandibular angle
is supplied by ant. Div. Of
greater auricular n.

52. 3 territories-
Upper territories- greater
part of forehead, lateral ½ of
eye lid, conjunctiva, lateral
part of cheek and parotid
area– preauricular lymph
node (parotid)
Middle territories- median
part of forehead, external
nose, upper lip, lateral part
of lower lip, medial ½ of eye
lid, medial part of cheek,
greater part of lower jaw–
submandibular lymph node
Lower territories- central
part of lower lip, chin– sub
mental lymph node

53.  Level I
Submental (IA)
Submandibular (IB)
 Level II
Upper jugular
 Level III
middle jugular
 Level IV
Lower jugular
 Level V
Posterior triangle group
(Spinal accessory and transverse
cervical chains)
 Level VI
Prelaryngeal
Pretracheal
Paratracheal
 Level VII
Nodes of upper mediastinum

54.  Level I includes :
 IA Submental nodes, which lie in the
submental triangle i.e. between right and
left anterior bellies of diagastric muscles
and the hyoid bone.
 IB Submandibular ones, lying between
anterior and posterior bellies of diagastric
muscle and the body of mandible

55. 55

56.  Level II – Upper
Jugular Nodes
 They are located
along the upper third
of jugular vein I.e.
between the skull
base above, and the
level of hyoid bone
(or bifurcation of
carotid artery) below

57.  Level III – Middle
Jugular Nodes
 They are located along
the middle third of
jugular vein, from the
level of hyoid bone
above, to the level of
upper border of
cricoid cartilage

58.  Level IV – Lower
Jugular Nodes
 They are located
along the lower
third of jugular
vein; from upper
border of cricoid
cartilage to the
clavicle

59.  Level V – Posterior Cervical Group
 They are located in the posterior triangle i.e.
between posterior border of
sternocleidomastoid(anteriorly), anterior
border of trapezius (posteriorly), and the
clavicle below. They include lymph nodes of
spinal accessary chain,transverse cervical
nodes and supraclavicular nodes

60.  Level VI – Anterior
Compartment Nodes
 They are located
between the medial
borders of
sternocleidomastoid
muscles (or carotid
sheaths) on each side,
hyoid bone above and
superasternal notch
below. They include
prelaryngeal,pretrache
al, paratracheal nodes

61.  Numerous fascial spaces in head and neck have
been described by:
 Collier and Yglesias,1935
 Grodinsky and Holyoke,1938
 Shapiro ,Sleeper,and Guralnick,1950
 Gaughran ,1957
 Laskin,1960
 Levit ,1970

62.  Shapiro defined fascial spaces as
potential spaces between the layer of
fascia. These spaces are normally
filled with loose connective tissue
and various anatomical structures like
veins, arteries, glands, lymphnodes.

63.  It is defined as a broad sheet of dense
connective tissue whose function is to
separate structure that must pass over
each other during movement such as
muscles & glands and serve as a pathway
for the course of vascular &neural
structure

64.  Fascia is described under:-
1) Superficial fascia
2)Deep fascia-
a) Superficial or anterior or investing layer
b) Middle or pretracheal layer.
c) Posterior or prevertebral layer.
d) Carotid sheath

65. Superficial fascia:-
 Similar to subcutaneous tissue
 Ensheathes platysma and muscles of facial
expressions
 Attachments : zygomatic process to thorax and
axilla
 Contents:platysma,muscles of facial expression

66. Superficial layer of deep cervical fascia
 Enveloping or investing layer
 Insertion at nuchal line of the skull
 Spreads anteriorly to the face and
attaches at clavicles
 Envelopes SCM,trapezius,portion of
omohyoid in posterior triangle,parotid
and submandibular glands

67.  Middle layer of deep cervical fascia
 Muscular division
 Attaches superiorly to hyoid and thyroid
and inferiorly to sternum ,clavicle and
scapula
 Visceral division
surrounds thyroid trachea, oesophagus
superiorly attached to base of skull thyroid
cartilge and hyoid

68.  This division has clinical significance
because
- below the hyoid bone the visceral layer
surrounds the trachea oesophagus and
thyroid gland.
- above the hyoid bone the visceral fascia
wraps around the lateral and posterior side of
the pharynx, lying on the superficial side of
pharyngeal constrictor muscle – known as
buccopharyngeal fascia

71.  Posterior layer - the posterior
layer of the deep cervical fascia
has two divisions
1) the alar
2) the prevertebral
The alar fascia passes through the
transverse process of the
vertebrae on either side, posterior
to the retropharyngeal fascia.

72.  The alar fascia fuses with
retropharyngeal fascia at a variable
level between 6th cervical and 4th
vertebrae
 Infection of the retro-pharyngeal
space may rupture the alar fascia,
thus entering the danger space ,
which is continuous with the
posterior mediastinum

73.  The prevertebral fascia surround the
vertebra and the attached postural
muscles of the neck & back
 Prevertebral fascia is usually not
invaded by infection arising in
maxillofacial regions.

74. Carotid sheath - Carotid sheath
surrounding IJV, CCA & vagus nerve is
interposed between the superficial and
pretracheal layer on the one hand and
prevertebral layer on the other.

75.  Grodinsky and Holyoke in1938,described
these potential spaces as
 Space 1
 Space 2
 Space 3 and 3A
 Space 4

76.  Space 1- the potential space superficial and
deep to the platysma muscle
 Space 2- the space behind the anterior layer
of deep cervical fascia
 Space 3- Pretracheal space- lies anterior to
trachea
 Space 3A- viscerovascular space-it is the
carotid sheath from jugular foramen and
carotid canal at the base of the skull to
pericardium or middle mediastinum

77.  Space 3A is also termed as lincoln’s highway
as coined by mosher
 Space 4 danger space is a potential space
between the alar and prevertebral fascia.it
extends from the base of the skull to posterior
mediastinum.

79.  Direct
Primary Spaces - Maxillary spaces
Mandibular spaces
 Indirect
Secondary spaces

80.  Maxillary Spaces – Canine
Buccal
Infratemporal
 Mandibular Spaces – Buccal
Submental
Submandibular
Sublingual

81.  Secondary Spaces –
 Massetric
 Pterygomandibular
 Superficial and deep temporal
 Parotid
 Lateral pharyngeal
 Retropharyngeal
 Prevertebral

83.  Face – Buccal
Canine
Masticatory
Parotid
 Suprahyoid - Sublingual
Submandibular
Pharyngomaxillary
Peritonsillar

84.  Infrahyoid - Pretracheal
 Spaces of total neck -Retropharyngeal
Space of carotid
sheath

85.  IN RELATION TO UPPPER JAW -
- WITH IN THE LIP
-WITH IN THE CANINE FOSSA,
-PALATAL SUBPERISTEAL INTERVAL,
-MAXILLARY ANTRUM
-INFRATEMPORAL FOSSA,
-SUBTEMPORALIS MUSCLE INTERVAL

86.  IN RELATION TO LOWER JAW -
 BUCCAL,
 SUBMENTAL,
 SUBMANDIBULAR,
 SUBLINGUAL,
 SUBMASSETRIC,
 PAROTID,
 PTERYGOMANDIBULAR,
 LATERAL PHARYNGEAL,
 PERITONSILLAR FOSSA

87.  Infection at the base of upper lip usually
occur as a result of an abscess of upper
incisors or canine
 If pus forms oral side of orbicularis oris,it
tends to point in vestibule
 Because of bulk of the muscle taking origin
beneath the anterior nasal spine,infection
from central incisors point towards the apex
of lateral incisors

88.  Boundaries
 Anteriorly –orbicularis
oris
 Posteriorly – buccinator
 Superorly – levator labi
superioris alaque nasi
levator labi superioris
zygomaticus minor
inferiorly - caninus
 medially -
anterolateral surface of
maxilla

89.  Contents –
angular artery
and vein
infraorbital nerve
 Involvement
canine
premolar
mesiobuccal root
of 1st
molar(rarely)

90.  Superoirly – overlying
periosteum and
mucosa
 Inferiorly – cortical
plate of hard palate
 Laterally - alveolar
process of maxilla
and teeth

91.  Involvement –palatal root of the posterior
teeth are the source of infection
 Occasionally,lateral incisor is frequent cause
,as infection migrate posteriorly

92.  SUPERIORLY : ZYGOMATIC ARCH
 INFERIORLY : LOWER BORDER OF
MANDIBLE
 ANTERIORLY : MODIOLUS OF MOUTH
 POSTERIORLY : PTERYGOMANDIBULAR
RAPHE
 MEDIALLY : BUCCINATOR MUSCLE
BUCCOPHARYNGEAL
FASCIA
 LATERALLY : SKIN OF CHEEK

93. Contents –
- parotid duct
- anterior fascial
artery & vein
- transverse fascial
artery & vein
- buccal fat pad

94. Source of infection: max bicuspid
max. molars
mand.molars
mand. Bicuspids
Spread- pterygomandibular space
infratemporal space
submasseteric space

95. Boundaries :
- Anteriorly – infratemporal surface of maxilla
- Posteriorly – mandibular condyle
- Superiorly – infra temporal crest of sphenoid
- Inferiorly – lateral pterygoid
- Medially – temporal tendon, coronoid
process
- Laterally – lateral pterygoid plate

96. Contents –
pterygoid plexus
internal maxillary artery & vein
mandibular nerve
Source of infection –
max. molars through infected needle
Spread - extended upwards to
involve temporal space.
 inferiorly – pterygomandibular
space.
 upwards into cavernous sinus

97.  Submental space -
Potential space present
just below the chin
region on the medial
surface of mandible
Boundaries –
 Superiorly: Mylohyoid
muscle
 Inferiorly: Deep fascia,
Platysma and Skin
 Laterally : Lower border
of mandible
 Anterior belly of digastric
muscle

98.  Contents - Submental lymphnodes
Anterior jugular vein
 Involvement – anterior mandibular
teeth
secondarily involvement due to
infection of submental lymph
nodes,following lymphatic spread
from lower incisors,lower lip,skin
overlying the chin,anterior part of
the floor of the mouth,tip of the
tounge and sublingual tissues

99.  Spread – infection
can spread
posteriorly,to involve
submandibular space
or may discharge on
the face,in submental
region

100. potential space lies between the ant. and
post. belly of digastric .
 Boundaries –
Anteriomedially : floor formed by
mylohyoid muscle
Posteriomedially : floor formed by
hyoglossus muscle
Superiolaterally : medial surface of
mandible below the mylohyoid ridge

101.  Anteriosuperiorly : ant. belly of digastric
 Posteriosuperiorly : post. belly of the
digastric ,stylohyoid and
stylopharyngeous muscle
 Laterally : platysma and skin
Contents : Superficial lobe of
submandibular salivary gland
Submandibular lymphnode ,facial
artery,proximal part of wharton’s
duct,lingual and hypoglossal nerve

102.  Involvement :
mandibular
molars,apices present
below the mylohyoid
insertion
Spread : Submental,
Submandibular
space on contralateral
side, Sublingual space,
Parapharyngeal space

104.  it is V-shape trough lying lateral to the muscles of
the tounge
 Boundaries :
Superiorly – mucosa of floor of mouth
Inferiorly - mylohyoid muscle
Medially- genioglossus,hyoglossus,geniohyoid
Laterally – medial side of mandible
Anteriorly - lingual surface of mandible
Posteriorly – submandibular space,hyoid bone

106.  Contents – geniohyoid, genioglossus, hyoglossus
muscle, deep part of submandibular salivary gland
and duct, sublingual salivary gland , lingual nerve
,hypoglossal nerve.
 Spread- infection may be cross the midline
- From posterioinferior part to submandibular gland
and space
- Via lymphatics to submental or submandible
lymphnodes

107. potential space present around the muscle of
mastication
 Submassetric
 Pterygoid
 Temporal

108. Boundaries
Anteriorly – anterior border of masseter muscle and
buccinator.
Posteriorly – parotid gland, posterior part of
masseter
Inferiorly – lower border of mandible
Medially – lateral surface of ramus of mandible
Laterally – medial surface of the masseter muscle

109. Contents –
- masseteric nerve
- superficial temporal
artery
- transverse facial
artery
- muscles of
mastication
- ramus and posterior
part of mandible
- Involvement – 3rd
molar infection

110. Boundaries-
Laterally – medial surface of ramus of
mandible Medially
– lateral surface medial pterygoid plate
Posteriorly – deeper portion of parotid
gland
Anteriorly – pterygomandibular raphe
Superiorly – lateral pterygoid muscle

112. Contents -
Lingual nerve
Mandibular nerve
Inferior alveolar artery
Mylohyoid nerve &
vessel
Spread: Infra temporal
fossa
Buccal space
Lateral & pterygoid
space
Submandibular space

113. It is secondary to the initial
involvement of
pterygopalatine & infra
temporal space.
Temporal pouches are facial
spaces in relation to the
temporalis muscle.
They are two :-
(i) Superficial temporal
space
(ii) Deep temporal space

114. Contents:-
Superficial-Superficial
temporal vessel
Auriculo temporal nerve
Deep – deep temporal
arteries & veins.

115.  Boundaries-
 formed by the splitting of the
supreficial layer of deep cervical
fascia surrounding the parotid
gland and lies to posterior to
masticatory space.
 Inferiorly-stylomandibular
ligament,which seprates parotid
space from mandibular space

116. Contents -
External carotid
artery
Posterior facial vein
Facial nerve
Lymph nodes

117. synonyms- pharyngomaxillary space
 Potential inverted cone shape,with its
base at the skull and its apex at the
hyoid bone.
 Lies deep to the pharyngeal
constrictor muscle
 Divided in to anterior and posterior
compartments by the styloid process

119.  Boundaries –
• Superiorly – base of the skull
• Inferiorly – hyoid bone
• Anteriorly – pterygomandibular raphe
• Posteroirly – bounded by
styloidmuscle,upper part of carotid
sheath,prevertebral fascia,
• Medially – bounded by pharyngeal wall , by
buccopharyngeal fascia
• Laterally – ascending ramus of
mandible,medial surface of deep lobe of
parotid glands

120.  Contents-
 Anterior compartment – lymphnodes,
facial artety
loose areolar
connective tissue
 Posterior compartment- carotid sheath
(IJV,ICA and Vagus nerve)
spinal accessory nerve
hypoglossal nerve
cervical sympathetic trunk

121. potential midline space between
pharyngobasillar fascia ,which attaches the
pharyngeal constrictor to base of skull,and
prevertebral fascia.
 Boundaries- laterally carotid sheath
- retropharyngeal space is continue with
retro-oesophageal space into posterior
mediastinum
-no midline attachments

123.  Medial—capsule of
palatine tonsil
 Lateral—superior
pharyngeal constrictor
 Superior—anterior
tonsil pillar
 Inferior—posterior
tonsil pillar

124.  Involvment-
 Infection coming from thedepth of tonsillar
crypt or supratonsillar fossa
 Complication of acute pericoronal abscess

125. POTENTIAL SPREAD
OF INFECTION
FROM LOWER
THIRD
MOLAR
SUPERIORLY
INFRATEMPORAL AND MASTICATOR SPACE
POSTERO INFERIORLY
PTERYGOMANDIBULAR
SPACE
INFERIORLY
SUBMANDIBULAR SPACE
LUDWIG’S ANGINA
ANTERIORLY,BUCCALY
BUCCAL SPACE
BUCCALY
MESSETRIC
SPACE

126.  A through knowledge of anatomy of
face and neck is necessary to predict
pathways of spread of infection and
drain the spaces adequately.
Otherwise the infection spread to such
an extent causing considerable
morbidity and occasional death.

127.  Oral and maxillofacial infections by Topazian
 Oral and maxillofacial surgery vol 2 by
Daniel M.Laskin
 Killey and kay’s outline of oral surgery
 Text book of oral and maxillofacial surgery
by Neelima A. Malik
 Grey’s anatomy
 Oral anatomy by Sicher and DuBrul’s
 Human anatomy by B.D.Chaurasia