Exploration of ultrasonography in assessment of fascial space spread of odontogenic infections

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Abstract

Objective.

The aim of this study was to explore the capability of ultrasonography (USG) as an alternative imaging modality to magnetic resonance imaging (MRI) in detection of fascial space spread of odontogenic infections.

Study design.

Forty-two fascial spaces in 16 subjects, clinically diagnosed as odontogenic infections, were included in this prospective study. The fascial space involvements were examined with USG. The results were confirmed by MRI and microbiologic tests.

Results.

Ultrasonography demonstrated 32 (76%) of 42 involved fascial spaces. There was 100% agreement between USG and MRI on 32 superficial space involvements, including 13 buccal, 10 submandibular, 5 canine, 2 submasseteric, 1 submental, and 1 infraorbital. Ultrasonography did not detect 4 masticator spacs, 4 parapharyngeal spacs, and 2 sublingual space involvements. Ultrasonography was able to stage infections starting from edematous change to cellulitis to complete abscess formation.

Conclusions.

Ultrasonography could be considered to be an effective method in detecting and staging spread of odontogenic infections to the superficial fascial spaces. However, it might be difficult to detect deep fascial space involvements.

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