Buccal space infections

Background

• Cellulitis or abscess in buccal space
  • Space between buccinator and superficial fascia/skin
• Odontogenic source
  • Maxillary second and third molars most common

Evaluation

• Ovoid cheek swelling with odontogenic disease
• CT not always necessary, but can define abscess

Differential Diagnosis

Facial Swelling

• Buccal space infections
• Dental problems
• Canine space infection
• Facial cellulitis
• Herpes zoster
• Masticator space infections
• Maxillofacial trauma
• Neoplasm
• Parapharyngeal space infection
• Salivary gland diagnoses
  • Parotitis
    • Bilateral parotitis
    • Suppurative parotitis
    • Viral parotitis (Mumps)
  • Ranula
  • Sialoadenitis
  • Sialolithiasis
• Superior vena cava syndrome

Management

• Parenteral Antibiotics coveral oral flora
  • Clindamycin, Penicillin V, 3rd gen Cephalosporin
• OMFS consult for abscess drainage, if present, and tooth extraction

Disposition

• OMFS/ENT consult
• Admit diabetics,immunocompompromised, discuss others with consultant

See Also

• Salivary Gland Infections

References

• ER Atlas
• Rosen