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

• Superior vena cava syndrome
• Buccal space infections
• Dental problems
• Masticator space infections
• Parapharyngeal space infection
• Neoplasm
• Maxillofacial trauma
• Facial cellulitis
• Canine space infection
• Salivary gland diagnoses
  • Viral parotitis
  • Suppurative parotitis
  • Sialolithiasis
  • Sialoadenitis

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

Authors

Mark Russell, Ross Donaldson, Daniel Eggeman, Neil Young, Daniel Ostermayer