Laterally, the DLDCF extends between the middle and anterior scalene muscles after which it invaginates outward around the brachial plexus and subclavian artery. Fascia does not have well-defined content and texture and varies in thickness and composition. PS, parotid space (red); PMS, pharyngeal mucosal space (blue); SMS, submandibular space (lateral purple).< div class='tao-gold-member'>. 35.1 to 35.3). With the use of broad-spectrum antibiotics as routine … Spaces of the suprahyoid head, neck and fascia. Head and neck fascia and compartments: No space for spaces. Cross sectional imaging is now commonly used to assist the clinical evaluation of head and neck lesions. Dr Francis Deng and Dr Samuel Wong et al. This fascial sheet thus closes the gap between the tensor veli palatini, the skull base, and the styloid process. This fat pad is intimately associated with the masticator space, and the fat has small projections into the pterygopalatine fossa along the lateral pterygoid muscle. Generally, the spread of infection is determined by barriers such as muscle, bone and fasciae. The upper portion is complex and formed by the SLDCF (from adjacent muscular fasciae), which forms the lateral wall; the DLDCF (alar and prevertebral fasciae), which forms the posterior wall; the cloison sagittale (either part of the DLDCF or the MLDCF), which forms the medial wall; and the stylopharyngeal aponeurosis (MLDCF), which forms the anterior wall. On each side of the neck, between the angle of the mandible and the anterior border of the SCM muscle, the SLDCF splits again to form the capsule of the parotid gland. The posterior-superior part of the MLDCF, also known as the buccopharyngeal fascia (BPF), extends from the skull base and follows the pharyngeal constrictors. The alar fascia is also the anterior wall of the danger space, which extends downward to the level of the diaphragm in the posterior mediastinum. Deep spaces of the head and neck. A thick fascial sheet extends inferiorly and posterolaterally to the styloid process from the posteroinferior edge of the tensor veli palatini muscle, fusing inferiorly with the fascia covering the styloglossus muscle. Neck spaces are potential fascial planes extending from the skull base to the mediastinum. It originates posteriorly from the vertebral spinous processes and extends anterolaterally under the trapezius muscle enveloping the muscles of the posterior triangle of the neck floor. The hyoid bone represents an essential boundary for anterior deep spaces of the neck, dividing these spaces into sub- and suprahyoid regions. The superficial cervical fascia (SCF) is a thin layer, investing loose connective and adipose tissue, platysma, … Space infections if detected early can be treated in clinics on outpatient basis by routine procedures such as extraction of offending tooth, root canal therapy and incision and drainage along with antibiotic therapy. Lateral to the sternum, the SLDCF attaches to the superior margin of the clavicle and extends to the spine of the scapula. • The cervical fascia is divided into superficial and deep layers, with the deep one further subdivided into superficial, middle, and deep layers. It extends from the superior aspect of the head down to the face where its fat content is dense, except around the eyelids. Fascial Spaces Infections usually only occupy one of these compartments, but severe or long standing infections can spread to involve the entire masticator space. They can be divided into superficial and deep neck space infections. • There are four distinct spaces between the pharynx and the vertebral bodies. Between it and the periosteum of the calvarium, there is loose areolar tissue that permits motion of the muscles of facial expression and can hold large accumulations of fluid. The blood supply to the pharynx varies based on anatomic location. The carotid sheath consists of contributions from all three layers of the DCF (Figs. In contrast, deep neck space infections (DNSI) are difficult to diagnose early. The space thus enclosed by these leaflets contains the muscles of mastication (the temporalis, masseter, and pterygoid). The potential prevertebral space lies between the vertebral bodies and prevertebral fascia. These potential spaces lie between the layers of the superficial fascia and deep layers of the cervical fascia surrounding the structures of the neck. 4. The alar fascia is also the anterior wall of the danger space, which extends downward to the level of the diaphragm in the posterior mediastinum. Alice K. Guidera BSc, MBChB. Must-know points of all these important modalities. Head and neck space infections of odontogenic origins can be life threatening if they remain untreated. More laterally, it continues parallel to the axillary sheath. It extends from the superior aspect of the head down to the face where its fat content is dense, except around the eyelids. Anteriorly, it fuses and crosses the midline of the neck in front of the strap muscles as a single fascia. Anteriorly, the fascia covering the masseter muscle curves medially to attach to the mandible. Join us as Dr. William provides us information about the Pharyngeal mucosal space, Parapharyngeal space, Masticator space, Parotid space, Carotid space, Retropharyngeal space, Perivertebral space. The SCF consists of a loose connective tissue that underlies the skin of the head and neck. Introduction. The muscular division extends inferiorly behind the sternum and then fuses with the pericardium and the great vessels in the superior mediastinum. The DCF is subdivided into three layers: (1.) The visceral space contains the pharynx, cervical esophagus, trachea, thyroid gland, parathyroid glands, larynx, recurrent laryngeal nerves, and portions of the sympathetic trunk (Fig. 35.4 and 35.5). The SLDCF is a well-defined sheet of fibrous tissue that completely envelops the neck. The superficial and deep leaflets of the SLDCF fuse along the dorsal border of the mandibular ramus. [2] Dysphagia (difficulty swallowing) and dyspnoea (difficulty breathing) may be a sign that the airway is being compressed by the swelling. Some areas have overlapping that gives added strength, while there may be focal dehiscences, especially along the medial wall, in other areas. The superficial and deep leaflets of the SLDCF fuse along the dorsal border of the mandibular ramus. The infra-temporal space is the inferior portion of the deep temporal space. From anterior to posterior: MS, masticatory space; PS, parotid space; PMS, pharyngeal mucosal space; CS, carotid space; PPS, parapharyngeal space; RPS, retropharyngeal space; DS, danger space; PVS, prevertebral space. The visceral division lies posterior to the strap muscles and extends from the pharyngeal constrictor muscles and hyoid bone down into the anterior mediastinum to attach the fibrous pericardium and great vessels. Within the neck, it contains loose fatty tissue and the platysma muscle. As such, familiarity with the anatomy and interconnections of the fasciae and spaces of the head and neck is crucial for planning a surgical approach.1,2 This last point in particular facilitates the teaching of deep spaces of the face and neck for students in … Cranial nerves (diagrams) Illustrations. These leaflets extend superiorly, enclosing the muscles of mastication and forming the masticator spaces. A-Z of COVID-19 - Radiology. Three layers of deep cervical fascia: superficial—red; middle—yellow; and deep—blue. The fascial spaces are compartments between the fascial layers that are filled with loose connective tissue (Figs. The superior pharynx receives its blood supply … The superficial cervical fascia (SCF) is a subcutaneous thick, well-defined layer of relatively loose connective tissue. It contains the carotid artery, internal jugular vein, cervical sympathetic chain, and cranial nerves IX, X, XI, and XII. The inferior and middle portions of the carotid sheath originate from the SLDCF (from the fascia covering the SCM) and from the DLDCF. Head and Neck Fascial Spaces Laterally, the fascia extends to the sternum, clavicle, and scapulae. Figure 35.1 Axial T1-magnetic resonance shows fascial spaces at the level of the nasopharynx. • Understanding the anatomy and the relationships between the fasciae of the head and neck and their spaces is mandatory for comprehending the manner of spread of most infections and some tumors. The fasciae of the head and neck are divided into superficial and deep layers (Figs. A thick fascial sheet extends inferiorly and posterolaterally to the styloid process from the posteroinferior edge of the tensor veli palatini muscle, fusing inferiorly with the fascia covering the styloglossus muscle. Potential pathways of spread into deep fascial space infections of the head and neck. The fascial spaces can also be opened during the dissection of a cadaver. Otolaryngol Head Neck Surg. Anteriorly, this fascia reaches the pterygomandibular raphe where it fuses with both the interpterygoid fascia and the BPF. The fasciae of the head and neck are divided into superficial and deep layers (Figs. Visceral Space Superiorly, it fuses with the thyroid cartilage and the hyoid bone. As a result, the compartments they create (i.e., the fascial spaces) are mostly ill-defined areas of relatively loose connective tissues that vary in their content. The SLDCF contains most portions of the anterior and external jugular veins. Ludwig's angina was the most commonly encountered infection seen in 38 (37%) patients, whereas prevertebral abscess was only seen in 1 (1%) patient. 35.1 to 35.3). the superficial layer of the deep cervical fascia (SLDCF), (2.) The posterior component is considered to have two subdivisions: an anterior pretracheal space and a more posterior retrovisceral space. Three layers of deep cervical fascia: superficial—red; middle—yellow; and deep—blue. Thin potential space on … Anteriorly and laterally, the PPS abuts the masticator and parotid spaces, respectively. The deep spaces of the head and neck refer to compartments delimited by the deep cervical fascia. Deep Layer of the Deep Cervical Fascia Between it and the periosteum of the calvarium, there is loose areolar tissue that permits motion of the muscles of facial expression and can hold large accumulations of fluid. Results: Of the total 103 patients with deep neck space infections (DNSI), odontogenic causes and suppurative lymphadenitis were responsible in 62 (60%) patients. Deep spaces of the head and neck. Two layers of fascia, superficial and deep, are commonly used to define the spaces of the neck. The carotid sheath consists of contributions from all three layers of the DCF (Figs. Visible Human Project. DrNikita Nanwani. The term “spaces” is inappropriate. 35.1 to 35.3). Their hypothesis was that infection in the head and neck mainly spread by hydrostatic pressure. The deep cervical fascia (DCF) is thinner and contains denser, more discrete layers. This fat pad is intimately associated with the masticator space, and the fat has small projections into the pterygopalatine fossa along the lateral pterygoid muscle. Integrated system-wise buzzwords and images. The danger space is composed of solely adipose tissue and, therefore, can be affected by non-nodal diseases. Both dental caries and periodontal disease are common conditions. It originates posteriorly from the vertebral spinous processes and extends anterolaterally under the trapezius muscle enveloping the muscles of the posterior triangle of the neck floor. Notice the relationship between spaces. Superiorly, the lateral pharyngeal space is limited by the … Epidemiology. Parotid space. Anteriorly, it fuses and crosses the midline of the neck in front of the strap muscles as a single fascia. This region extends from the skull base down to the upper mediastinum. Core Messages English Radiology. The anterior component is covered anteriorly by the strap muscles, laterally by the carotid sheaths, and posteriorly by the alar fascia. The superficial leaflet overlies the masseter muscle and attaches to the zygomatic arch. The muscles of mastication are enclosed in a layer of fascia, formed by cervical fascia ascending from the neck which divides at the inferior border of the mandible to envelope the area. Users learn the different fascial layers and the network of fascial spaces (including how they connect with one another). These spaces communicate freely at the levels of the thyroid cartilage and the inferior thyroid artery. Laterally, the fascia extends to the sternum, clavicle, and scapulae. Medially, as the DLDCF reaches the anterior aspect of the vertebral bodies, it divides into the prevertebral fascia and the alar fascia. The fascial spaces are different from the fasciae themselves, which are bands of connective tissue that surround structures, e.g. Its upper part is limited anteriorly by the BPF, posteriorly by the alar fascia, and laterally by the cloison sagittale fasciae. Notice the relationship between spaces. Deep Cervical Fascia • The cervical fascia is divided into superficial and deep layers, with the deep one further subdivided into superficial, middle, and deep layers. The lateral group, named the nodes of Rouvière, persists throughout adulthood and can become a site of metastasis for head and neck cancers. This space is bounded anterolaterally by the fascia covering the masticator space, posterolaterally by the parotid space, medially by the su- perior constrictor muscle of the pharynx, and posteriorly by the styloid Volume 11 SURGICAL ANATOMIC SPACES OF HEAD AND NECK 347 Number 4 muscle and carotid bundle. While these concepts overlap with traditional anatomical description, their existence highlights the importance of fascia in confining various pathologies. the deep layer of the deep cervical fascia (DLDCF).4–6 From anterior to posterior, they are (1) the visceral space, (2) the retropharyngeal space, (3) the danger space, and the (4) prevertebral space. The fascia at this point splits once again to enclose the zygomatic arch, creating a small space over the superior surface of the arch that is filled with fat. Perivertebral space. Fascial spaces (also termed fascial tissue spaces or tissue spaces ) are potential spaces that exist between the fasciae and underlying organs and other tissues. Ended on Mar 20, 2021. The DCF is subdivided into three layers: (1.) Laterally, the DLDCF separates the lower neck and the thorax by extending from the transverse process of C7 to attach to the medial surface of the first rib, covering the dome of the pleura. • The superficial fascia and the superficial layer of the deep fascia surround the entire neck. the middle layer of the deep cervical fascia (MLDCF), and (3.) Within the neck, it contains loose fatty tissue and the platysma muscle. In health, these spaces do not exist; they are only created by pathology, e.g. the spread of pus or cellulitis in an infection. As such, the spaces can also be classified according to their relation to the upper and lower teeth, and whether infection may directly spread into the space (primary space), or must spread via another space (secondary space): The submaxillary space is a historical term for the combination of the submandibular, submental and sublingual spaces, which in modern practice are referred to separately or collectively termed the perimandibular spaces. As it forms the floor of the submandibular space, it fuses and covers the anterior belly of the digastric and mylohyoid muscles. Understanding the anatomy and the relationships between the fasciae of the head and neck and their spaces is mandatory for comprehending the manner of spread of most infections and some tumors. It extends from the skull base down to the coccyx. Danger space. Jan 15, 2021 • 2h 7m . [4] Confusion exists, as some sources[5] describe the sublingual and the submandibular spaces as compartments of the "submandibular space". The deep leaflet of the SLDCF extends cranially to form the medial or inner boundary of the masticator space. Superficial Fascia Importantly, many of these spaces extend into the mediastinum. Notice the relation between spaces. 24 Infections of the Fascial Spaces of the Head and Neck. • Understanding the anatomy and the relationships between the fasciae of the head and neck and their spaces is mandatory for comprehending the manner of spread of most infections and some tumors. The fascial spaces are different from the fasciae themselves, which are bands of connective tissue that surround structures, e.g. 35.1 and 35.2). The SLDCF contains most portions of the anterior and external jugular veins. The anterior component is covered anteriorly by the strap muscles, laterally by the carotid sheaths, and posteriorly by the alar fascia. An infected jugular vein thrombus caused by extension of an oropharyngeal infection is referred to as Lemierre's syndrome. More laterally, it continues parallel to the axillary sheath. Potential space, bilaterally located in the chin, between the mentalis muscle superiorly and the platysma muscle inferiorly. [4], Deep temporal space (infra-temporal space), mandibular division of the trigeminal nerve, https://en.wikipedia.org/w/index.php?title=Fascial_spaces_of_the_head_and_neck&oldid=975597156, Creative Commons Attribution-ShareAlike License, Fascial spaces traversing the length of the neck, This page was last edited on 29 August 2020, at 11:57. CS, carotid space; DS, danger space; PS, parotid space; PVS, prevertebral space; RPS, retropharyngeal space; VS, visceral space. It extends from the skull base down to the level of the C6-T4 vertebrae. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed that certain fasciae restricted the growth of some tumors, whereupon knowledge of the anatomy of these fasciae opens the way to understand a disease process and predict its growth patterns. From anterior to posterior: MS, masticatory space; PS, parotid space; PMS, pharyngeal mucosal space; CS, carotid space; PPS, parapharyngeal space; RPS, retropharyngeal space; DS, danger space; PVS, prevertebral space. It splits to enclose the more cranial portion of the levator muscle, and a lateral leaflet of the BPF lies in close association with the lateral margin of the tensor veli palatini muscle. Those containing neurovascular tissue (nerves and blood vessels) may also be termed compartments. Otolaryngol Clin North Am. Patients present to … SCF covers the head, face, and neck and contains the platysma, the muscles of facial expression, and portions of the anterior and external jugular veins. The infratemporal space is the inferior portion of the deep temporal space. The deep cervical fascia (DCF) is thinner and contains denser, more discrete layers. The anatomical location and borders of head and neck lesions … The MLDCF encloses the anterior neck. The space thus enclosed by these leaflets contains the muscles of mastication (the temporalis, masseter, and pterygoid). When the SLDCF reaches the mandible, the fascia divides into superficial and deep leaflets. This should not only enhance our understanding of cervical anatomy but also facilitate clearer interdisciplinary communication. English Radiology. 9M watch mins. Lateral to the sternum, the SLDCF attaches to the superior margin of the clavicle and extends to the spine of the scapula. Some head and neck spaces transgress both the suprahyoid and infrahyoid neck. Superficial and deep layers of the DCF merge at the ligamentum nuchae. The potential prevertebral space lies between the vertebral bodies and prevertebral fascia. The primary content of this space is fat and a communicating vein between the left and right anterior jugular veins. The prevertebral fascia adheres directly to the vertebral bodies and cervical muscles and serves as the posterior wall of the danger space. From anterior to posterior, they are (1) the visceral space, (2) the retropharyngeal space, (3) the danger space, and the (4) prevertebral space. © 2014 Wiley Periodicals, Inc. Head Neck 36: 1058–1068, 2014 CS, carotid space; DS, danger space; PS, parotid space; PVS, prevertebral space; RPS, retropharyngeal space; VS, visceral space. CS, carotid space; DS, danger space; MS, masticatory space; PMS, pharyngeal mucosal space; PPS, parapharyngeal space; PS, parotid space; PVS, prevertebral space; RPS, retropharyngeal space. Thrombosis of the internal jugular vein is an under-diagnosed condition that may occur as a complication of head and neck infections, surgery, central venous access, and intravenous drug abuse. It then crosses the posterior triangle of the neck and splits again to enclose each sternocleidomastoid (SCM) muscle. The visceral division lies posterior to the strap muscles and extends from the pharyngeal constrictor muscles and hyoid bone down into the anterior mediastinum to attach the fibrous pericardium and great vessels. Figure 35.4 Coronal T1-magnetic resonance image shows suprahyoid fascial spaces. This chapter reviews the major anatomic descriptions of the fasciae and spaces of the head and neck.3, The fasciae of the head and neck are divided into superficial and deep layers (Figs. Skull (Illustrations) Illustrations. The masticator spaces are paired structures on either side of the head. This fascia contains the ascending palatine artery and vein. Fascial area are potential areas between layers of fascia. PS, parotid space (red); PMS, pharyngeal mucosal space (blue); SMS, submandibular space (lateral purple). • There are four distinct spaces between the pharynx and the vertebral bodies. The paranasal sinuses consist of the maxillary, sphenoid, and frontal sinuses, as well as the ethmoid air cells. The neck can be divided into suprahyoid and infrahyoid spaces by the hyoid bone. • The superficial fascia and the superficial layer of the deep fascia surround the entire neck. the deep layer of the deep cervical fascia (DLDCF).4–6. This connection explains why a retropharyngeal abscess can extend down into the pretracheal space and affect the thyroid gland and anterior mediastinum, and why a large thyroid goiter can extend behind the esophagus and grow either upward as a retropharyngeal mass or downward as a retroesophageal mass. Wikipedia. Hoang JK, Branstetter BF 4th, Eastwood JD, et al. Inferiorly in the midline, the SLDCF splits to attach the anterior and posterior aspects of the manubrium. Proximity of the fascial spaces to various vital structures may cause devastating complications, such as airway obstruction, jugular septic thrombophlebitis, lung abscess, upper airway abscess rupture with asphyxiation, mediastinitis, pericarditis, and septic shock. The superficial cervical fascia consists of the subcutaneous tissues of the head and neck. Prevalence … Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), 9 Parapharyngeal Space Surgery in the Pediatric Population, 14 Branchial Cleft Anomalies, Sinuses, and Cysts, 2 The Distinctive Anatomical Features of the Pediatric Skull Base, 3 Special Considerations in Pediatric Anesthesia and Pain Control, 31 Surgical Approach to the Lateral Skull Base, 26 Endoscopic Sinus Surgery in Children for Benign Lesions. Other spaces, more posterior, are not interrupted by the hyoid bone and extend the entire length of the neck. … Other contents such as salivary glands, blood vessels, nerves and lymph nodes are dependent upon the location of the space. Its location is anterior to the prevertebral muscles and posterior to the pharynx and esophagus. THE CONCEPT OF FASCIAL “SPACES” IS BASED ON ANATOMIST’S KNOWLEDGE THAT … Communication between spaces is variable and considered as normal anatomic variation.9,10. Medially, as the DLDCF reaches the anterior aspect of the vertebral bodies, it divides into the prevertebral fascia and the alar fascia. The three layers of the DCF envelop the contents of the head and neck and form the deep neck spaces.8. Masticator space. The superficial cervical fascia (SCF) is a subcutaneous thick, well-defined layer of relatively loose connective tissue. the spread of pus or cellulitis in an infection. Dr. Zainab Vora. It contains sensory nerves, superficial vessels, and lymphatics. Proximity of the fascial spaces to various vital structures may cause devastating complications, such as airway obstruction, jugular septic thrombophlebitis, lung abscess, upper airway abscess rupture with asphyxiation, mediastinitis, pericarditis, and septic shock. The deep cervical … The RPS is divided by the alar fascia into two … The SLDCF is a well-defined sheet of fibrous tissue that completely envelops the neck. [4] They injected a dye into cadavers to simulate pus. Understanding the anatomy and the relationships between the fasciae of the head and neck and their spaces is mandatory for comprehending the manner of spread of most infections and some tumors. The fascia covering the masseter muscle attaches to the buccinator fascia and to the maxilla, creating the masticator fat pad. English Ophthalmology. It has two parts, a muscular one, which encases the infrahyoid strap muscles (sternothyroid, sternohyoid, and thyrohyoid), and a visceral one, which envelops the trachea, larynx, pharynx, esophagus, and the thyroid gland. Corresponding Author. The fascial layers limit and … 2007;136(2):182-188. 35.5). The pterygomandibular space lies between the medial side of the ramus of the mandible and the lateral surface of the medial pterygoid muscle. Department of Surgical Sciences, Dunedin School of Medicine, Dunedin, New Zealand . Head and neck space infections Varqa Larawin, MMed , James Naipao, MMed , and Siba P. Dubey, MS Otolaryngology–Head and Neck Surgery 2016 135 : 6 , 889-893 The external carotid artery and the retromandibular vein perforate the parotid gland capsule and pass through it. Above the hyoid bone, the SLDCF extends superiorly to the lower border of the mandible. [7] The term submaxillary may be confusing to modern students and clinicians since these spaces are located below the mandible, but historically the maxilla and mandible together were termed "maxillae", and sometimes the mandible was termed the "inferior maxilla". It contains the carotid artery, internal jugular vein, cervical sympathetic chain, and cranial nerves IX, X, XI, and XII. It arises from the ligamentum nuchae of the cervical vertebra and extends laterally and splits to enclose each trapezius muscle. • The cervical fascia divides the neck into several distinct spaces. The SCF consists of a loose connective tissue that underlies the skin of the head and neck. Debnam JM, Guha-Thakurta N. Retropharyngeal and prevertebral spaces: anatomic imaging and diagnosis. The mastoid air cells lie predominantly within the … This connection explains why a retropharyngeal abscess can extend down into the pretracheal space and affect the thyroid gland and anterior mediastinum, and why a large thyroid goiter can extend behind the esophagus and grow either upward as a retropharyngeal mass or downward as a retroesophageal mass. It arises from the ligamentum nuchae of the cervical vertebra and extends laterally and splits to enclose each trapezius muscle. World Cancer Day, head and neck cancer: The symptoms of head and neck cancers include a lump or a sore that does not heal, a persistent sore throat, difficulty in swallowing, and a … The PPS parapharyngeal space (yellow) and the SLS sublingual space (medial purple) communicate at the posterior border of mylohyoid muscle. The DCF travels along the neck below the skull base and encloses the muscles of the neck, as well as the mandible and the muscles of mastication and deglutition. Male cadaver. Three layers of the deep cervical fascia (DCF): superficial (red), middle (yellow), and deep (blue). muscles. Its upper part is limited anteriorly by the BPF, posteriorly by the alar fascia, and laterally by the cloison sagittale fasciae. In some cases, these compartments represent potential spaces. It extends from the sternum to halfway up the neck. 10 article feature images from this case. The middle layer of the deep cervical fascia encircles the center of the anterior neck to contain the viscera of the neck. Figure 35.2 Axial T1-magnetic resonance shows fascial spaces at the level of the nasopharynx. Inferiorly in the midline, the SLDCF splits to attach the anterior and posterior aspects of the manubrium. Fasciae Describe fascial planes and spaces of the neck and other relevant head and neck anatomic landmarks. Fascial Spaces of Head and Neck region. Anteriorly, this fascia reaches the pterygomandibular raphe where it fuses with both the interpterygoid fascia and the BPF. The alar fascia lies anteriorly to the prevertebral fascia and forms the posterior wall of the retropharyngeal space. Multiplanar CT and MRI of collections in the retropharyngeal space: is it an abscess? These leaflets extend superiorly, enclosing the muscles of mastication and forming the masticator spaces. Moran Amit and Dan M. Fliss 35.1 and 35.2). The deep layer of the deep cervical fascia encircles the spine and the paraspinal muscles. In the head and neck, potential spaces are primarily defined by the complex attachment of muscles, especially mylohyoid, buccinator, masseter, medial pterygoid, superior constrictor and orbicularis oris.[6]. Head (CT) CT. As a result, the compartments they create (i.e., the fascial spaces) are mostly ill-defined areas of relatively loose connective tissues that vary in their content.
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