Canine space

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Canine space
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Lateral view of the maxilla, showing infra-orbital area, including the canine fossa, and muscle attachments.
Anatomical terminology

The canine space (also termed the infra-orbital space), [1] is a fascial space of the head and neck (sometimes also termed fascial spaces or tissue spaces). 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. [1] [2] 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.

Contents

Diagram showing muscles of infra-orbital region. The levator labii superioris muscle is colored red. Canine space boundaries 1 (Levator labii superioris edit).png
Diagram showing muscles of infra-orbital region. The levator labii superioris muscle is colored red.
Diagram showing muscles of the infra-orbital region. Levator anguli oris is colored red. The canine space is situated between the levator anguli oris muscle and the levator labii superioris muscle. Canine space borders 2 (Levator anguli oris edit).png
Diagram showing muscles of the infra-orbital region. Levator anguli oris is colored red. The canine space is situated between the levator anguli oris muscle and the levator labii superioris muscle.

Structure

Boundaries

The boundaries of the canine space are: [2]

Communications

The canine space communicates with the buccal space posteriorly. [2]

Function

Contents

The contents of the canine space are: [2]

Clinical significance

Canine space infections may occur by spread of infection from the buccal space. [2] Signs and symptoms of a canine space abscess might include swelling that obliterates the nasolabial fold. If left untreated, infections of this space will eventually spontaneously drain via the medial or lateral canthus of the eye, as this is the path of least resistance. [2] Treatment is usually by surgical incision and drainage, and the incision is placed inside the mouth to avoid a facial scar.

Rarely, when infections of the canine space erode into the infra-orbital vein or the inferior ophthalmic vein (via the sinuses), there can be spread via the common ophthalmic vein through the superior orbital fissure and into the cavernous sinus. This can result in septic cavernous sinus thrombosis, which is a rare, but life-threatening condition. [2]

Odontogenic infection

Odontogenic infections may spread to involve the canine space. The most likely causative tooth is the maxillary canine or maxillary first premolar. [1] This occurs when pus (e.g. from a periapical abscess), perforates the buccal cortical plate of the maxilla above the level of attachment of the levator anguli oris muscle. This is more likely if the tooth root is long (the maxillary canine has the longest root of all the teeth), and its apex lies at a level above the muscle attachment. [1]

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Modiolus (face)

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Pterygoid plexus

The pterygoid plexus is a venous plexus of considerable size, and is situated between the temporalis muscle and lateral pterygoid muscle, and partly between the two pterygoid muscles.

Infraorbital artery

The infraorbital artery is an artery in the head that branches off the maxillary artery, emerging through the infraorbital foramen, just under the orbit of the eye.

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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.

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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.

Submental space fascial space of the head and neck

The submental space is a fascial space of the head and neck. It is a potential space located between the mylohyoid muscle superiorly, the platysma muscle inferiorly, 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.

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.

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 4 Hargreaves KM; Cohen S, eds. (2010). Cohen's pathways of the pulp. Berman LH (web editor) (10th ed.). St. Louis, Mo.: Mosby Elsevier. pp. 590–594. ISBN   978-0-323-06489-7.
  2. 1 2 3 4 5 6 7 Hupp JR, Ellis E, Tucker MR (2008). Contemporary oral and maxillofacial surgery (5th ed.). St. Louis, Mo.: Mosby Elsevier. pp.  317–333. ISBN   9780323049030.