Submandibular Area Research Articles

Solitary Myofibroma of the oral and maxillofacial regions in pediatric patients: A clinicopathological analysis of ten patients and review of 75 cases

BackgroundThe imaging manifestations of oral and maxillofacial myofibroma/myofibromatosis can vary among patients. Although many clinical cases have been reported, a consensus on the clinicopathological features of and treatment principles for this disease is lacking. PurposeThis study aimed to summarize the clinicopathological features of solitary myofibroma of the oral and maxillofacial regions in pediatric patients. MethodsThe clinical data, histological features, and immunohistochemical characteristics of ten pediatric patients who underwent surgical removal and subsequent pathological diagnosis of myofibroma were collected and retrospectively and cross-sectionally analyzed. ResultsSeven patients were male, and 3 were female, with ages ranging from 3 months to 6 years (mean: 2.6 years). The patients presented with solitary lesions involving the mandibular gingiva and adjacent mandible (4 patients), mandible (2 patients), oral floor and submandibular area and adjacent mandible (1 patient), gingiva (1 patient), maxilla (1 patient), and oropharynx (1 patient). Light microscopy revealed spindle-shaped tumor cells organized in bundles or vortex patterns, forming a hemangiopericytoma-like perivascular pattern, whereas immunohistochemical staining revealed diffuse smooth muscle actin (SMA) positivity. All patients underwent surgical resection, and none experienced recurrence over the 12- to 82-month follow-up. ConclusionsSolitary myofibroma in the oral and maxillofacial regions is predominantly observed in infants and young children, with a higher incidence among males. The prognosis is favorable following localized lesion resection or curettage of jawbone lesions. Accurate recognition of the clinical, radiological, and pathological features of the disease will reduce the misdiagnosis rate.

Lymph Node Evolution in Eyelid and Orbit Squamous Cell Carcinomas.

To describe a large cohort of eyelid and periorbital SCCs, to compare the location of the tumor and of the pathological lymph nodes, and to analyze the risk factors for lymph node involvement among tumor characteristics. All patients managed inside our institution for an eyelid and periorbital SCCs were included. Tumor characteristics, imaging setup, excision margins, lymph node evolution features, local, regional, and distant recurrences rates, and global survival were reported. The risk for lymph node involvement and location of pathological lymph nodes were analyzed through univariate and multivariate analyses. Between January 2012 and August 2022, 115 patients were included, and 18 presented a lymph node evolution (15.7%), involving the parotid gland in 16 cases (88.9%), the submental and submandibular areas in seven cases (38%), and the jugular and carotid areas in four cases (22%). Tumor size above 20 mm, infiltration of the external canthus and periorbital structures, the presence of perineural invasion or vascular embolism, the depth of infiltration, and the presence of a local recurrence were significantly associated with the risk of lymph node evolution. Periorbital and eyelid SCCs present a true potential for lymph node evolution especially through the parotid gland. Extension setup including the parotid gland and neck should be mandatory, and lymph node dissection should be associated in case of parotidectomy for lymph node involvement. IV Laryngoscope, 2024.

Rare case of Lingual Nerve Schwannoma Presenting as Submandibular Area Swelling with Parapharyngeal Extension.

Schwannoma is a rare benign encapsulated nerve sheath tumor which originates from Schwann cells. Generally, schwannoma arising from lingual nerve involves the oral tongue and tongue base in the oral cavity. We report a rare case of lingual nerve schwannoma in a 16-year-old girl with complaint of right-side submandibular swelling for last 4-5 years. A diagnosis was established based on computed tomography (CT scan) and fine needle aspiration cytology (FNAC). CT scan showed tumor involving right submandibular region and superiorly reaching up to parapharyngeal space without any intraoral swelling. She underwent excision under general anesthesia (transcervical approach) without any complication. Per operatively, the tumor was found eccentrically placed with relation to the lingual nerve and lingual nerve fibers were splayed over the tumor. The final histopathological results confirmed the diagnosis of schwannoma.

Phleboliths, not Sialoliths: a submandibular gland venous malformation: case report and literature review

Although venous malformations occurring in the submandibular gland are extremely rare, most have been diagnosed as "hemangiomas". Based on the literature review very few cases of submandibular gland venous malformation were reported for the last 55 years. We provide one of this rare cases; A 62-year-old female patient presented with swelling in the left submandibular area for 6 months with no complaints of xerostomia nor suppuration from the salivary ducts. Ultrasound Sonography test of the neck and CT scan revealed an heterogenous lesion in left submandibular area with multiple calcifications. The mass was surgically excised, the histopathological examination reported a submandibular gland venous malformation with phleboliths. Low-flow vascular malformations of the head and neck region can develop phleboliths that may be mistaken for sialoliths given the similar calcified nature and location specially in salivary gland area. Appropriate history, clinical examination and investigation leads to the correct diagnosis and treatment.

EFFECT OF INTEGRATED TREATMENT ON REPARATIVE REGENERATION OF WOUNDS AND BONE DEFECTS IN CHILDREN WITH ODONTOGENEOUS PHLEGMONS

The achievements of modern septic surgery are associated with the implementation of the latest technologies and new generations of pharmacological drugs, the action of which is aimed at correcting existing disorders. Recently, special literature has presented encouraging data regarding the effectiveness of placenta cryoextract in treating inflammatory processes of the maxillofacial area. However, little attention has been given to its application in children.
 Objective of this study is to investigate the effectiveness of comprehensive treatment on the processes of reparative regeneration in wound and bone tissue in children with odontogenic phlegmons.
 Subjects and methods. In order to assess the course of the wound process, 29 children with phlegmons localized directly in the submandibular area were selected; the length of the incision was 5 cm. In the first group, involving 16 people, a set of measures was carried out in accordance with the medical care protocol, and in the second group, consisting of 13 patients, on the second day after the operation, an aseptic bandage with "Levomekol" ointment was applied to the wound surface with the addition of cryoextract of the placenta in ratios of 5:1. In order to objectify the results, pH-metry of the wound exudate was performed, a planimetric study was performed to establish the speed of retraction of the wound edges, and the cellular composition of the wound exudate was analyzed for 1, 3, and 8 days. On the first day after surgery, changes in these parameters in both groups were of the same type. On the third day, in the second group of children, the pH level improved by 9.5%, and the speed of retraction of the wound edges increased by 9.0% compared to the first group. On the 8th day, the concentration of hydrogen ions in this group increased by 9.4%, and the average area of the wound surface became smaller by 8.2% compared to the previous values. The cellular composition of the cytograms also indicated the advantages of wound healing in this group of patients. In the first group, comprising 16 individuals, a standard set of measures was implemented following the medical care protocol. In the second group, consisting of 13 patients, an aseptic bandage with "Levomekol" ointment, supplemented with cryoextract of placenta at a ratio of 5:1, was applied to the wound surface on the second post-operation day. To objectively assess the outcomes, pH-metry of the wound exudate was conducted, alongside planimetric studies to determine the rate of wound edge retraction. Additionally, the cellular composition of the wound exudate was analyzed at 1, 3, and 8 days post-operation. On the first day after the operation, both groups exhibited similar changes in these parameters. However, by the third day, the second group demonstrated a 9.5% improvement in pH levels and a 9.0% increase in the speed of wound edge retraction compared to the first group. By the eighth day, the second group displayed a 9.4% rise in hydrogen ion concentration, and the average wound surface area decreased by 8.2% compared to previous measurements. Furthermore, cytogram analysis indicated superior wound healing advantages in this group of patients.
 Conclusion. The comparison of clinical and laboratory indicators at the observation stages allowed us to determine that the combined application of topical "Levomekol" ointment with the additional incorporation of placenta cryoextract in its composition improves the conditions of the wound healing process. This improvement is evidenced by the dynamics of changes in the pH indicator, the results of planimetry, and the cellular composition of the exudate.

Salivary Duct Carcinoma Arising in the Submandibular Gland in a Patient with Neurofibromatosis Type 1.

A 71-year-old man with neurofibromatosis type 1 (NF1) presented to our department with a 1-week history of a painful mass in the left submandibular area. Computed tomography (CT) and magnetic resonance imaging revealed an irregular-shaped tumor with a diameter of 2.0 cm in the left submandibular gland and a metastatic lymph node with a diameter of 1.0 cm adjacent to the tumor. Fluorodeoxyglucose-positron emission tomography/CT revealed increased uptake in the tumor. Fine-needle aspiration cytology revealed atypical cells, suggesting salivary duct carcinoma (SDC). Left neck dissection with resection of the tumor and submandibular gland was performed under general anesthesia. Histologic examination revealed ductal formation with a solid, cystic, cribriform, and papillary structure with intraductal comedonecrosis, diagnosing as SDC originating in the submandibular gland (pT3N1M0 pStage III). Mutational analysis of 160 cancer-related genes by next-generation sequencing (NGS) revealed a germline and frameshift mutation in the NF1 gene (p.R2408Kfs*14) and a somatic and frameshift mutation in the TP53 gene (p.C176Wfs*22). The patient received postoperative radiotherapy to the left neck area at 66 Gy. No evidence of recurrence or metastasis has been observed as of 10 months postoperatively. This is the first reported case of SDC in the submandibular gland in a patient with NF1. The mutational data by NGS may contribute to a better understanding of the oncogenesis of SDC in patients with NF1.

Treatment of nasolabial fold rhabdomyosarcoma in children: A single-institution experience.

To summarize the clinical characteristics and prognosis of children with nasolabial fold rhabdomyosarcoma (RMS). Retrospective review of children treated for nasolabial fold RMS from January 2014 to September 2019. Of 21 patients with nasolabial fold RMS, 90.48% were alveolar subtype, in which PAX3/7-FOXO1 fusion positive accounted for 87.5%. Ten patients (47.62%) had nodals invasion. Almost all patients received comprehensive treatment (chemotherapy [100%], radiation therapy [100%], and surgery [95.24%]). The median follow-up time was 34.3 months. The 3-year overall survival (OS) and event-free survival (EFS) was 67.7% ± 14.1% and 42.1% ± 13.5%, respectively. Four patients had regional lymph node relapse (NR), all in the ipsilateral submandibular lymph node region. Majority of the patients with RMS in the nasolabial fold area were alveolar subtype and had positive PAX3/7-FOXO1 gene fusion. In addition, the nasolabial fold RMS had a high probability of regional lymph node metastasis in the submandibular area. To maintain the facial aesthetics and functions, the surgical area for nasolabial fold RMS is often very conservative and restricted. This could be one of the contributors for the poor prognosis of nasolabial fold RMS beside its worse pathological subtype and gene fusion.

Effectiveness of a physiotherapy protocol in a patient with dysphagia following radiotherapy for squamous cell carcinoma in retromolar trigone: A case report

Abstract Background: Squamous cell carcinoma (SCC) in the retromolar trigone of the oral cavity is an aggressive form of cancer, often leading to dysphagia as a result of radiotherapy (RT). This case report examines the efficacy of a combined physiotherapy protocol in treating RT-associated dysphagia. Case Presentation: A 43-year-old male diagnosed with SCC, displaying significant difficulty swallowing post-RT, was subjected to a 4-week physiotherapy treatment. The protocol incorporated swallowing exercises, such as lip protrusion/retraction, tongue retraction, and maneuvers including the Mendelsohn maneuver and effortful swallow, complemented by neuromuscular electrical stimulation (NMES) at the submandibular area. Outcomes: Posttreatment assessment revealed notable improvement in the patient’s swallowing capability, with increased scores on the Functional Oral Intake Scale (FOIS) and MD Anderson Dysphagia Inventory. Conclusion: The application of swallowing exercises combined with NMES may offer a promising approach to ameliorate dysphagia symptoms in patients post-RT for SCC. Further research is warranted to validate these findings and optimize treatment protocols.

Surgical Treatment Tumors Giant Size of the Submandibular Area

Lipomas of the submandibular space are relatively rare. The prevalence is 1% of all lipomas in the body. A lipoma may contain elements other than blood vessels of adipose tissue, muscle fibers, fibroconnective tissue, and bone tissue. Fibrolipomas of the submandibular zone are rare and account for approximately 3-4% of all head and neck tumors. With large tumors of the submandibular region, facial deformation appears. The larger the tumor, the greater the deformation of the face and neck. This report describes a case of a giant fibrolipoma in the submandibular space. We present a case of a 50-year-old man with a tumor of the right submandibular zone. The tumor appeared 8 years ago and the patient was not treated. The tumor had a locally widespread form and spread to the paropharyngeal area. Due to the difficulty of administering incubation anesthesia and taking into account possible postoperative complications, the patient underwent a tracheotomy under local anesthesia at the first stage and a radical removal of a giant tumor was performed at the second stage. Postoperative histology - Fibrolipoma. In this case, due to the large size of the tumor, in addition to deformation of the face and neck, the patient had impaired functions of swallowing food, difficulty breathing and speaking. In the postoperative period, a satisfactory aesthetic and functional result was achieved. Postoperative wound healing was primary; there were no complications.

Atypical Presentation of Ramsay Hunt Syndrome: A Case Report

Background: This case emphasizes the atypical presentation of Ramsay Hunt syndrome (RHS), in which the rash was distributed over cervical dermatomes (C3, C4). Case Presentation: A 55-year-old Sudanese woman presented with left-side mouth deviation and difficulty in the closure of her right eye which happened two weeks after the appearance of a vesicular rash over the right side of her head, ear, down to the right side of her neck as well as submandibular area, and improved with treatment (acyclovir and prednisolone). Conclusion: Physicians should be aware of typical and atypical presentations of RHS to facilitate prompt diagnosis and provide appropriate management. Early intervention with antiviral and corticosteroids has been shown to significantly improve outcomes in these patients.

A Case of Follicular Dendritic Cell Sarcoma in Submandibular Region

Follicular dendritic cell sarcoma (FDCS) is rare lymphoid sarcoma occurs anywhere in body, mostly in lymph nodes. Sixty-two-year-old man presented left submandibular gland region mass for 5 months. Mass excision with submandibular gland resection was performed. Histopathology showed proliferation of spindle and ovoid cells with storiform arrangement which were positive for CD21, CD23, Vimentin, Ki-67, suggested FDCS in submandibular gland region lymph node. Tumor size was 3cm with no involvement of resection margin, nor cellular atypia and necrosis, so regular follow up was performed. After 4 years, new enhancing mass in left submandibular area was found. Wide excision of mass with neck dissection on left level I-III was performed. Histopathology confirmed recurrence of FDCS. The patient underwent radiation therapy from left mandible to hyoid area. After 2 years, new nodule was found in left lung upper lobe, and wedge resection confirmed metastasis of FDCS. The patient is on adjuvant chemotherapy.

Cervical Aggressive Fibromatosis Causing Airway Obstruction.

Fibromatosis or desmoid tumors are rare benign fibroblastic lesions that are rarely present in the head and neck regions. When they do occur in these regions, however, they tend to be aggressive toward the surrounding tissue and be associated with heavy morbidity and mortality. We report the case of a 26-year-old Tunisian female who presented with acute obstructive dyspnea and a 3-week history of cervical swelling. The swelling was initially only located in the left submandibular area, it then gradually extended to all the anterior cervical supra- and infrahyoid regions causing a clinical presentation resembling that of obstructive dyspnea, the patient was admitted, and an emergency tracheotomy was performed. Tissue samples were taken, pathological analysis revealed an aggressive case of fibromatosis. The patient was treated with corticosteroids and antihormonal therapy, the fibrous mass shrunk considerably allowing the removal of the tracheotomy cannula, no tumor recurrence was noted during the observation period. Due to the rarity of this disease, especially in the cervical region, there are no therapeutic guidelines available.

Ultrasonographic Evaluation of Salivary Glands for Sjogren's Syndrome: Diagnostic and Monitoring Insights.

Sjogren's syndrome (SS) is a chronic autoimmune condition commonly affecting the exocrine glands, causing oral or ocular dryness and extraglandular manifestations including arthralgia, cytopenia, and lymphoma. The presence of autoantibodies against SSA/Ro, labial salivary gland biopsy, ocular staining, Schirmer's test, or salivary flow assessment are included in the current classification criteria of SS. However, the availability and invasiveness of these procedures limit their widespread use in clinical settings. Salivary gland ultrasonography (SGUS) is a non-invasive imaging modality for the evaluation of the salivary gland parenchyma and is increasingly utilized to aid diagnosis and monitoring in SS. This article presents the protocol of SGUS for image acquisition at the parotid and submandibular glands. The objective is to present a standardized, reproducible, and practical approach to diagnostic SGUS for SS in daily clinical settings. Major salivary glands are scanned in a stepwise approach, beginning at the angle of the mandible for the superficial lobe of the parotid gland, followed by the deep lobe below the ramus of the mandible. Submandibular areas are then scanned for the submandibular glands. The steps in obtaining salivary gland images at each anatomical site are explained in the accompanying video. The echogenicity and echotexture at the thyroid gland are taken as a reference. The homogeneity, the presence and distribution of hypoechoic areas within the glands, and the border of the salivary glands are examined. The sizes and features of intra-/peri-glandular lymph nodes are recorded. The most distinctive sonographic feature in SS is glandular heterogeneity with the presence of hypoechoic/hyperechoic areas within the glands. In summary, while SGUS cannot diagnose SS on its own, it can supplement the current classification criteria of SS and guide the clinical decision for salivary gland biopsy to support the diagnosis of SS in patients with sicca syndrome or suspicious systemic features, combined with autoantibody testing.

Changes of the facial soft tissue after mandibular reconstruction using vascularized iliac flap.

To reveal the change patterns of the facial soft tissue after applying mandibular reconstruction. 16 Patients with mandibular benign tumor were recruited in this retrospective study. For all patients, segmental mandibular osteotomy and concurrent reconstruction using vascularized iliac flap were conducted. The soft tissue thickness of patients' lower face was measured with CT scans before surgery, 1week, 6months and 1year after surgery. The time-dependent changes of tissue thickness were analyzed. The most significant tissue swelling was 28.86%, at 1week after the surgery. The average increase of tissue thickness was 4.78 ± 5.30mm across patient. After 1year of the surgery, tissue thickness decreased to the level before operation or the level of the healthy side. The thickness of the low-density tissue fluctuated mildly, while the thickness of the high-density tissue fluctuated significantly. The disuse atrophy of the masseter occurred 1week after the surgery, and was reversed after 1year. The removal of the submandibular gland caused depression in submandibular area, which intensified over time. Across patients, soft tissue thickness in the lower face after mandibular osteotomy and reconstruction increased significantly 1week after the surgery, and decreased over time. After 1year, tissue thickness went back to the pre-surgery level, where matched up with the healthy side. We documented the change patterns of the facial soft tissue after mandibular reconstruction. These results can help improve the planning of virtual surgeries and the timing for aesthetic assessment. ClinicalTrials.gov Identifier: ChiCTR2100054103.

995 Cavernous Sinus Thrombosis Secondary to Dental Neglect

Abstract Background Cavernous sinus thrombosis is a rare, potentially life-threatening condition often caused by a cervicofacial bacterial infection. Prompt diagnosis and management improve prognosis and help prevent permanent complications. Clinical case A 54-year-old man with a background of alcohol excess attended the emergency department following a collapse at home. He presented with a potassium of 1.5 and a firm right parotid swelling with associated facial nerve weakness and was admitted to ICU for management of severe sepsis and electrolyte disturbance. CT imaging out of hours showed swelling of right parotid and submandibular areas and generalised oedema parapharyngeally. Further clinical examination by the maxillofacial team noted a right sided 6th nerve palsy, raising concern about intracranial spreading infection from a dental source and MRI was requested. The patent continued to deteriorate and developed bilateral chemosis and proptosis. MRI scan confirmed bilateral cavernous sinus thrombosis and right cerebral hemisphere subdural collection and the patent was transferred to a neurosurgical unit for a craniotomy, temporal lobe washout and dental clearance. Upon further review of imaging by a specialist head and neck radiologist the cavernous sinus thrombosis was noted on the initial scans. Conclusions Raise awareness of this condition and its management – much rarer more now due to antibiotics in developed world. Importance of thorough clinical examination to pick up subtle signs such as cranial nerve palsies. Vital to have multidisciplinary involvement in diagnosis and management; both radiology to help with diagnosis and neurosurgery, ENT and maxillofacial to carry out surgery as required.

Cone beam computed tomography use in sialolithiasis of the submandibular salivary gland

A 62-year-old diabetic male patient presented with right sided facial pain associated with a firm palpable mobile mass in the right submandibular area. Following initial examination, cone beam computed tomography (CBCT) investigation demonstrated multiple smooth homogenous calcifications (Figure 1) collectively measuring 12mm x 9mm x 8mm within the region of the right submandibular gland (Figure 2). On resection of the submandibular gland, the histological features of the lesion were confirmed to be those of chronic sclerosing sialadenitis supporting the clinical impression of a sialolith.

Mediastinitis due to Odontogenic Infection

Mediastinitis due to the spreading of odontogenic infection is rare, but the mortality rate is high. This report presents the case of mediastinitis caused by the spreading of odontogenic infection in healthy males. The patient complained of dyspnoea and trismus. The diffuse and fluctuating swelling was observed in the submandibular and submental area, which spreads to the neck and chest. It was diagnosed mediastinitis as a submandibular and submental abscess complication due to the impacted teeth’ pericoronitis. Two drainage incisions were made following the administration of oxygen and antibiotics injection. The success of mediastinitis treatment due to the spread of odontogenic infection is determined by proper diagnosis and appropriate initial management. Antibiotic administration and pus drainage are the very decisive stage of treatment to reduce the risk of death. It is necessary to eliminate the causative of odontogenic infection.

Successful Intraductal Sialolithiasis Removal Using Sialendoscopy: A Case Report and Surgical Video Tips

Introduction: Sialolithiasis is major cause of the obstructive salivary gland disease, accounting for ~60% of all cases. Other etiologies include strictures, mucoid debris, anatomic ductal abnormalities, and scar tissue.1 About 80% to 95% of sialolithiasis cases occur in the submandibular gland, 5% to 20% in the parotid gland, and only 1% to 2% in the remaining glands. The treatment of the obstructive salivary gland has evolved in the past 25 years with the introduction of thin semiflexible endoscopes and microinstruments such as forceps, baskets, wires, lasers, and balloons. These advancements allow for sialendoscopy and other intraductal manipulations including stone removal, dilatation of strictures, and cleansing of mucus plugs.2 In addition, these procedures can be used in combination with minimally invasive external approaches.3 Sialendoscopy is the main option for effectively treating these obstructive conditions, leading to improvements in overall quality of life.4 The objective of the surgical video is to clarify the basic steps involved in effectively removing intraductal sialolithiasis. Materials and Methods: A 36-year-old man presented with complaints of pain, swelling, and difficulty swallowing during meals, in the right submandibular salivary gland area. The symptoms had been present for the past 2 years and had worsened progressively, with no improvements with analgesics. The patient had a history of drinking less water during the past 10 years, but otherwise had no remarkable medical history. During the neck clinical examination, the right submandibular gland was found to be smaller than the contralateral gland, and no atypical lymph nodes were detected. Intraoral examination revealed a palpable 8 mm sialolith in the right floor of the mouth, which caused a discharge of milky saliva on manipulation. The remaining mucosa appeared normal. A CT scan revealed a 9 mm elliptical sialolith in the middle third of the right submandibular duct, consistent with the clinical examination and suspicion of obstructive sialolithiasis. Laboratory tests were normal. As treatment, sialendoscopy was indicated. The procedure was conducted following the standards set by Marchal et al.5 The intervention was performed for both diagnostic and therapeutic interventions, using a semirigid modular sialendoscope (Karl Storz, Tuttlingen, Germany) with a diameter of 1.7 mm, along with working channel, salivary probes, conic dilatators, bougies, baskets for stones, dilatator balloons, and silastic stents to the main duct to maintain papilla patency.6 The sialolith was completely removed without any adverse events. Results: The patient recovered uneventfully postoperatively and was discharged the next day. Conclusion: Our findings support the use of sialendoscopy for obstructive sialolithiasis. Patients usually obtain a complete resolution of their clinical symptoms and the technology has a high success rate when performed by an experienced team. The patient who agreed to participate in the study has written and signed the informed consent statement. No competing financial interests exist. No funding was received for this article. Runtime of video: 4 mins 49 secs

Submandibular Injury Caused by the Close-Range Firing of a Military Blank Cartridge Shot

Few studies have reported injuries caused by a blank cartridge shot (BCS) into the head and neck. We experienced a case of minor injury resulting from BCS (despite the close proximity). The patient was a 20-year-old male soldier who attempted suicide by firing a BCS from a K2 rifle into his mouth. He suffered from skin and soft tissue defect in the submandibular area with burns and minimal bleeding. A computed tomography scan showed subcutaneous emphysema which was suspected to be related to the projectile gas released during the firing of the BCS, and a tiny fragment without hematoma or structure injuries. We closely observed the clinical features including the occurrence of infection and functional abnormalities. The subcutaneous emphysema faded away along with the soft tissue defect. After wound management was completed on the 13<sup>th</sup> hospital day, the patient was transferred to the Department of Psychiatry without any problems.

Epidemiological Analysis and Management of Patients with Facial Space Infections of Odontogenic Origin: A Retrospective Evaluation of Two Years

Objective: Odontogenic infections are one of the most common pathologies in the oral and maxillofacial regions. The spread of odontogenic infections after unsuccessful or late treatment can lead to serious complications. The aim of this study is to examine the epidemiological features and treatment management of patients with odontogenic facial abscesses.
 Methods: This retrospective study included 88 patients with odontogenic facial area abscesses treated at Afyonkarahisar health sciences university, faculty of dentistry’s maxillofacial surgery clinic between 2019-2021. The socio-demographic, socio-economic characteristics and clinical examination findings of the patients and treatment methods for odontogenic abscess were analyzed comprehensively. Data were
 evaluated using SPSS-20 and the level of significance was set at p < .05.
 Results: In the two-year period between 2019 and 2021, 88 patients (44 male and 44 female, mean age was 39.72±16.42) were treated for diffuse facial infections of odontogenic origin. The most commonly involved area was the submandibular area (38.6%), the most affected tooth was mandibular 1st molar and mandibular 3rd molars (18.2%), and the most common cause was dental caries (65.90%). Incision and drainage were performed in half of the patients (36.4% intraoral, 13.6% extraoral). The most commonly used drugs were clindamycin (36.4%), amoxicillin-clavulanate, and ornidazole combination (27.3%).
 Conclusion: The results of this study confirm that odontogenic abscesses can heal without complications with timely and effective basic interventions such as incision and drainage. In this study, successful results were obtained with the parenteral clindamycin, and a combination of oral amoxicillin-clavulanate and ornidazole in the treatment of odontogenic abscesses.