Fascial Space –

Submandibular space
Prepared by : Ang Shang Rong
D20100903
 “The concept of fascial space is based on the
anatomist’s knowledge that all “spaces” exist only
potentially, until fasciae are separated by pus,
blood, drains, or a surgeons finger”.
 CLASSIFICATION
-Based on mode of involvement-
Direct Involvement (Primary space)

1. Mandibular – Submandibular, Sublingual, submental, buccal

2. Maxillary – buccal, canine, infratemporal

Indirect Involvement (Secondary space)- massetric, preveterbral, superficial&deep temporal,

parotid, retropharyngeal, lateral pharyngeal

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 Etiology of Submandibular Space
1. Indirect infection ( spread from other space [submandibular salivary gland/
submental space/ sublingual space/ tongue , floor of mouth & cheek]
2. Infected mandibular 2nd & 3rd molars
3. Pericoronitis
4. Fracture angle

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 Boundaries of submandibular space
S u p e r i o r l y : mylohyoid muscle,
inferior border of mandible.
I n f e r i o r l y : anterior & posterior
belly of digastric.
L a t e r a l l y : deep cervical fascia,
platysma, superficial fascia & skin.
M e d i a l l y : hyoglossus,
styloglossus, mylohyoid muscle.
P o s t e r i o r l y : hyoid bone.
A n t e r i o r l y : submental space.
 Content Of Submandibular Space
1. Submandibular salivary gland and lymph
nodes
2. Lingual and Hypoglossal nerves
3. Proximal portion of Wharton’s Duct
4. Facial artery and its branches
( palatine, tonsillar, glandular, submental )
5. Facial vein

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 Clinical Feature
Of Submandibular Space
Lymphadenopathy
1. Painful swelling (Brawny, Indurated,
Soft, Fluctuant ) at the angle of the jaw
2. Elevation of tongue
3. Inability to palpate
4. Trismus
5. Lymphadenopathy Trismus - jaws do not open fully.
 Treatment
Of Submandibular Space
Medical Method Surgical Method
1. Antibiotics 1. Incision ( extraorally below lower
border of the mandible )
- Penicilin
2. Blunt dissection
- Amoxicillin
3. Rubber drain
- Cephalosporins 4. A/B administration
2. Analgesics 5. Fluid replacement ( rehydration )

- NSAID’s 6. Bed rest

3. Antiseptic wash mouth

 References
1. R.G Topazian , Oral & Maxillofacial Infections 4th edition • Journal of Oral and
Maxillofacial Surgery, Volume 72, Issue 9, Supplement, September 2014, Pages
e83-e84 
2. https://www.slideshare.net/Vaishk/submandibular-space-infection
3. lo2lo226 Follow. (n.d.). Oral and maxillofacial spaces of infection. SlideShare.
https://www.slideshare.net/lo2lo226/oral-and-maxillofacial-spaces-of-
infection.
4. Arjun Shenoy Face & Jaw Surgeon Follow. (n.d.). Fascial Space Infection part 2.
SlideShare. https://www.slideshare.net/ArjunShenoy3/fascial-space-infection-
part-2.
5. YouTube. (2020, December 5). Submandibular Space Infection - Treatment by Dr.
Raman Dhungel. YouTube. https://www.youtube.com/watch?v=TErwVkYrdTM.

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Thank you
Any Question ?

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