Submental space

Last updated
Submental space
Submental space (Gray507 edit).png
Submental space situated on the superficial surface of mylohyoid muscle, medial to the anterior belly of the digastric muscle (highlighted in green).
Submental space (Gray386 edit).png
Left half of the submental space (right side of diagram has digastric muscle removed).
Details
Identifiers
Latin Spatium submentale
Anatomical terminology

The submental space is a fascial space of the head and neck (sometimes also termed fascial spaces or tissue spaces). It is a potential space located between the mylohyoid muscle superiorly, the platysma muscle inferiorly, [1] under the chin in the midline. The space coincides with the anatomic region termed the submental triangle, part of the anterior triangle of the neck.

Contents

Location and structure

Anatomic boundaries

The boundaries of the submental space are:

Communications

The communications of the submental space are:

Contents

Its contents are submental lymph nodes, areolar connective tissue and the anterior jugular veins.

Clinical relevance

This space may be created by pathology, such as the spread of pus in an infection. Odontogenic infection of the mandibular anterior teeth may erode through the lingual cortical plate of the mandible. If the level at which the infection breaks out of the mandible is below the attachment of the mylohyoid, then it will spread into the submental space. [1] However, it is more usual for odontogenic infections to spread into the submental space via first involving the submandibular space. Cutaneous infections or symphyseal/parasymphyseal mandibular fractures may also give rise to a submental space infection. Signs and symptoms of a severe submental abscess include a firm swelling below the chin and dysphagia (difficulty swallowing). Treatment is by surgical incision and drainage, with the incision running transversely in a skin crease behind the chin.

Ludwig's angina is a progressive cellulitis involving the submandibular, sublingual and submental spaces bilaterally. Ludwig's angina may extend into the pharyngeal and cervical spaces, and the swelling can compress the airway and cause dyspnoea (difficulty breathing). [1]

Related Research Articles

Submandibular gland

The paired submandibular glands are major salivary glands located beneath the floor of the mouth. They each weigh about 15 grams and contribute some 60–67% of unstimulated saliva secretion; on stimulation their contribution decreases in proportion as the parotid secretion rises to 50%.

Sublingual gland major salivary glands in the mouth

The paired sublingual glands are major salivary glands in the mouth. They are the smallest, most diffuse, and the only unencapsulated major salivary glands. They provide only 3-5% of the total salivary volume. There are also two other types of salivary glands; they are submandibular and parotid glands.

Ludwigs angina human disease

Ludwig's angina is a type of severe cellulitis involving the floor of the mouth. Early on the floor of the mouth is raised and there is difficulty swallowing saliva, which may run from the person's mouth. As the condition worsens, the airway may be compromised with hardening of the spaces on both sides of the tongue. This condition has a rapid onset over hours.

Mylohyoid muscle paired muscle

The mylohyoid muscle is a paired muscle running from the mandible to the hyoid bone, forming the floor of the oral cavity of the mouth. It is named after its two attachments near the molar teeth. These muscles are mesodermal in embryologic origin. The mylohyoid muscle is derived from the first pharyngeal arch. It forms the floor of the submental triangle.

Facial artery branch of the external carotid artery

The facial artery is a branch of the external carotid artery that supplies structures of the superficial face.

Hyoglossus

The hyoglossus, thin and quadrilateral, arises from the side of the body and from the whole length of the greater cornu of the hyoid bone, and passes almost vertically upward to enter the side of the tongue, between the styloglossus and the inferior longitudinal muscle of the tongue. It forms a part of the floor of submandibular triangle.

Anterior triangle of the neck region of the neck

The anterior triangle is a region of the neck.

Deep cervical fascia invests the muscles of the neck

The deep cervical fascia lies under cover of the platysma, and invests the muscles of the neck; it also forms sheaths for the carotid vessels, and for the structures situated in front of the vertebral column. Its attachment to the hyoid bone prevents the formation of a dewlap.

Submental artery

The submental artery is a branch of the facial artery that runs on the underside of the chin.

Buccal space fascial space of the head and neck

The buccal space is a fascial space of the head and neck. It is a potential space in the cheek, and is paired on each side. The buccal space is superficial to the buccinator muscle and deep to the platysma muscle and the skin. The buccal space is part of the subcutaneous space, which is continuous from head to toe.

Investing layer of deep cervical fascia most superficial part of the deep cervical fascia

The Investing layer of deep cervical fascia is the most superficial part of the deep cervical fascia, and it encloses the whole neck.

Mouth infections, also known as oral infections, are a group of infections that occur around the oral cavity. They include dental infection, dental abscess, and Ludwig's angina. Mouth infections typically originate from dental caries at the root of molars and premolars that spread to adjacent structures. In otherwise healthy patients, removing the offending tooth to allow drainage will usually resolve the infection. In cases that spread to adjacent structures or in immunocompromised patients, surgical drainage and systemic antibiotics may be required in addition to tooth extraction. Since bacteria that normally reside in the oral cavity cause mouth infections, proper dental hygiene can prevent most cases of infection. As such, mouth infections are more common in populations with poor access to dental care or populations with health-related behaviors that damage one's teeth and oral mucosa. This is a common problem, representing nearly 36% of all encounters within the emergency department related to dental conditions.

Sublingual space fascial space of the head and neck

The sublingual space is a fascial space of the head and neck. It is a potential space located below the mouth and above the mylohyoid muscle, and is part of the suprahyoid group of fascial spaces.

Submandibular space fascial space of the head and neck

The submandibular space is a fascial space of the head and neck. It is a potential space, and is paired on either side, located on the superficial surface of the mylohyoid muscle between the anterior and posterior bellies of the digastric muscle. The space corresponds to the anatomic region termed the submandibular triangle, part of the anterior triangle of the neck.

Mental space (anatomy)

The mental space is a fascial space of the head and neck. It is a potential space, bilaterally located in the chin, between the mentalis muscle superiorly and the platysma muscle inferiorly. These spaces may be created by pathology, e.g., the spread of odontogenic infection. Commonly the origin of the infection is an anterior mandibular tooth with associated periapical abscess which erodes through the buccal cortical plate of the mandibular at a level below the attachment of the mentalis muscle.

Fascial spaces are potential spaces that exist between the fasciae and underlying organs and other tissues. In health, these spaces do not exist; they are only created by pathology, e.g. the spread of pus or cellulitis in an infection. The fascial spaces can also be opened during the dissection of a cadaver. The fascial spaces are different from the fasciae themselves, which are bands of connective tissue that surround structures, e.g. muscles. The opening of fascial spaces may be facilitated by pathogenic bacterial release of enzymes which cause tissue lysis. The spaces filled with loose areolar connective tissue may also be termed clefts. Other contents such as salivary glands, blood vessels, nerves and lymph nodes are dependent upon the location of the space. Those containing neurovascular tissue may also be termed compartments.

Submasseteric space fascial space of the head and neck

The submasseterric space is a fascial space of the head and neck. It is a potential space in the face over the angle of the jaw, and is paired on each side. It is located between the lateral aspect of the mandible and the medial aspect of the masseter muscle and its investing fascia. The term is derived from sub- meaning "under" in Latin and masseteric which refers to the masseter muscle. The submasseteric space is one of the four compartments of the masticator space. Sometimes the submasseteric space is described as a series of spaces, created because the masseter muscle has multiple insertions that cover most of the lateral surface of the ramus of the mandible.

Pterygomandibular space fascial space of the head and neck

The pterygomandibular space is a fascial space of the head and neck. It is a potential space in the head and is paired on each side. It is located between the medial pterygoid muscle and the medial surface of the ramus of the mandible. The pterygomandibular space is one of the four compartments of the masticator space.

Canine space

The canine space, is a fascial space of the head and neck. It is a thin potential space on the face, and is paired on either side. It is located between the levator anguli oris muscle inferiorly and the levator labii superioris muscle superiorly. The term is derived from the fact that the space is in the region of the canine fossa, and that infections originating from the maxillary canine tooth may spread to involve the space. Infra-orbital is derived from infra- meaning below and orbit which refers to the eye socket.

Infratemporal space

The Infratemporal space is a fascial space of the head and neck. It is a potential space in the side of the head, and is paired on either side. It is located posterior to the maxilla, between the lateral pterygoid plate of the sphenoid bone medially and by the base of skull superiorly. The term is derived from infra- meaning below and temporal which refers to the temporalis muscle.

References

  1. 1 2 3 Kenneth M. Hargreaves; Stephen Cohen; Louis H.Berman, eds. (2010). Cohen's pathways of the pulp (10th ed.). St. Louis, Mo.: Mosby Elsevier. p. 590. ISBN   978-0323064897.