| 词条 | Pterygomandibular space |
| 释义 |
| Name = Pterygomandibular space | Latin = | Image = Gray383.png | Caption = Diagram showing left medial and lateral pterygoid muscles. Part of the zygomatic arch and the ramus of the mandible have been cut away. The pterygomandibular space lies between the lateral surface of medial pterygoid and the medial surface of the mandibular ramus. | Width = | Image2 = Masticator space.png | Caption2 = The four compartents of the right masticator space. A Temporalis muscle, B Masseter muscle, C Lateral pterygoid muscle, D Medial ptaerygoid muscle, E Superficial temporal space, F Deep temporal space, G Submasseteric space, H Pterygomandibular space, I Approximate location of infratemporal space | Precursor = | System = | Artery = | Vein = | Nerve = | Lymph = }} The pterygomandibular space is a fascial space of the head and neck (sometimes also termed fascial spaces or tissue spaces). 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.[1] Location and structureAnatomic boundariesThe boundaries of each pterygomandibular space are:[1]
CommunicationsThe communications of each pterygomandibular space are:[1]
ContentsIn health, the space contains:
Clinical relevanceThe pterygomandibular space is the area where local anesthetic solution is deposited during an inferior alveolar nerve block, a common procedure used to anesthetize the distribution of the inferior alveolar nerve. Rarely, pathogenic micro-organisms from the mouth may be seeded into the pterygomandibular space during this injection and cause a needle tract infection of the space.[1] It is also occasionally reported that the needle breaks off and is retained in the pterygomandibular space during this injection.[3] Minor oral surgery is then required to remove the fractured needle.[3] Due to its high vascularity, injections into the pterygomandibular space carry a high risk of intravascular injection (injecting into a blood vessel).[4] Another possible complication of an inferior alveolar nerve block occurs when the needle is placed too deep, passing through the pterygomandibular space and into the parotid gland behind. Branches of the facial nerve (which gives the motor supply to the muscles of facial expression) run through the substance of the parotid gland and so this is manifest as a transient facial palsy. The pterygomandibular space is one of the possible spaces into which a tooth may be displaced into during dental extraction, e.g. of a maxillary wisdom tooth.[5] A mandibular fracture in the angle region may also be the cause of a pterygomandibular space infection.[1] The signs and symptoms of an isolated pterygomandiublar infection may include trismus (difficulty opening the mouth), however there is not usually any externally visible facial swelling.[1] Intra-orally, there may be swelling and erythema (redness) or the anterior tonsillar pillar (the Palatoglossal arch) and deviation of the uvula to the unaffected side.[1] The airway may be compressed. Treatment is by surgical incision and drainage, and the incision may be placed inside the mouth or two incisions may be used, one inside the mouth and one outside.[1] Odontogenic infectionsOdontogenic infections may spread to involve the pterygomandibular space, and the most common teeth responsible for this are the mandibular second and third molar teeth.[6]References1. ^1 2 3 4 5 6 7 8 9 {{cite book|vauthors=Hupp JR, Ellis E, Tucker MR |title=Contemporary oral and maxillofacial surgery|year=2008|publisher=Mosby Elsevier|location=St. Louis, Mo.|isbn=9780323049030|pages=317–333|edition=5th}} {{mouth anatomy}}{{Digestive tract}}2. ^{{cite journal|last=Khoury|first=JN|author2=Mihailidis, S |author3=Ghabriel, M |author4= Townsend, G |title=Applied anatomy of the pterygomandibular space: improving the success of inferior alveolar nerve blocks.|journal=Australian Dental Journal|date=June 2011|volume=56|issue=2|pages=112–21|pmid=21623801|doi=10.1111/j.1834-7819.2011.01312.x}} 3. ^1 {{cite journal|last=Bedrock|first=RD|author2=Skigen, A |author3=Dolwick, MF |title=Retrieval of a broken needle in the pterygomandibular space.|journal=Journal of the American Dental Association|date=May 1999|volume=130|issue=5|pages=685–7|pmid=10332133|doi=10.14219/jada.archive.1999.0278}} 4. ^{{cite journal|last=Taghavi Zenouz|first=A|author2=Ebrahimi, H |author3=Mahdipour, M |author4=Pourshahidi, S |author5=Amini, P |author6= Vatankhah, M |title=The Incidence of Intravascular Needle Entrance during Inferior Alveolar Nerve Block Injection.|journal=Journal of Dental Research, Dental Clinics, Dental Prospects|date=Winter 2008|volume=2|issue=1|pages=38–41|pmid=23285329|pmc=3533637 |doi=10.5681/joddd.2008.008}} 5. ^{{cite journal|last=Ozer|first=N|author2=Uçem, F |author3=Saruhanoğlu, A |author4=Yilmaz, S |author5= Tanyeri, H |title=Removal of a Maxillary Third Molar Displaced into Pterygopalatine Fossa via Intraoral Approach.|journal=Case Reports in Dentistry|year=2013|volume=2013|pages=1–4|pmid=23476814|pmc=3580928|doi=10.1155/2013/392148}} 6. ^{{cite book|last=Hargreaves KM, Cohen S (editors), Berman LH (web editor)|title=Cohen's pathways of the pulp|year=2010|publisher=Mosby Elsevier|location=St. Louis, Mo.|isbn=978-0-323-06489-7|pages=590–594|edition=10th}} 4 : Fascial spaces of the head and neck|Mouth|Otorhinolaryngology|Oral and maxillofacial surgery |
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