SURGICAL FASCIAL SURGICAL FASCIAL SPACESSPACES

Definit ionDefinit ion

The fascial spaces in head and neck are the The fascial spaces in head and neck are the potential spaces between the various layers of potential spaces between the various layers of fascia normally filled with loose connective tissue fascia normally filled with loose connective tissue (Shapiro) and bounded by anatomical barriers, (Shapiro) and bounded by anatomical barriers, usually of bone, muscle or fascial layers (Moore).usually of bone, muscle or fascial layers (Moore).

FASCIA OF HEAD AND NECKFASCIA OF HEAD AND NECK SUPERFICIAL FASCIASUPERFICIAL FASCIA DEEP CERVICAL FASCIA DEEP CERVICAL FASCIA A.A. ANTERIOR LAYERANTERIOR LAYER 1. Investing layer1. Investing layer 2. Parotideomesseteric2. Parotideomesseteric 3.Temporal3.Temporal B. MIDDLE LAYERB. MIDDLE LAYER 1.Sternohyoid-omohyoid division1.Sternohyoid-omohyoid division 2.Sternothyroid-thyrohyoid division2.Sternothyroid-thyrohyoid division 3.Visceral division3.Visceral division a. Buccopharyngeal a. Buccopharyngeal b. Pretracheal b. Pretracheal c.Retropharyngealc.Retropharyngeal C. POSTERIOR LAYERC. POSTERIOR LAYER a. Alar Divisiona. Alar Division b. Prevertebral division b. Prevertebral division

CLASSIFICATION OF FASCIAL CLASSIFICATION OF FASCIAL SPACESSPACES

MODE OFINVOLVEMENT

1º maxillaryspaces

1º mandibularspaces

2º fascialspaces

• Submental • Submandibular • Sublingual • Buccal

• Massetric • Pterygomandibular • Sup. & deep temp. • Lateral pharyngeal • Retropharyngeal • Prevertebral• Parotid space

•Canine • Buccal • Infratemporal

GRODINKSY & HOLYOKE

Space I Space II Space III Space IV

III IIIA

Space superficial & deep to platysma

Space behind anterior layer of deep cervical fascia

Pretracheal space

Viscero- vascular space

(Lincoln’s highway- Mosher)

Danger space – potential space between alar &

prevertebral fascia

PRIMARY MAXILLARY SPACESPRIMARY MAXILLARY SPACES

INFRAORBITAL OF CANINE INFRAORBITAL OF CANINE SPACE SPACE

BUCCAL SPACE BUCCAL SPACE

INFRATEMPORAL SPACEINFRATEMPORAL SPACE

PRIMARY MANDIBULAR PRIMARY MANDIBULAR SPACESSPACES

SUBMANDIBULAR SPACESUBMANDIBULAR SPACE

SUBLINGUAL SPACESUBLINGUAL SPACE

SUBMENTAL SPACESUBMENTAL SPACE

MASTICATORY SPACESMASTICATORY SPACES

SUB MASSETERIC SPACESUB MASSETERIC SPACE

PTERYGOMANDIBULAR PTERYGOMANDIBULAR SPACESPACE

SUPERFICIAL TEMPORAL SUPERFICIAL TEMPORAL SPACESPACE

SECONDARY FASCIAL SECONDARY FASCIAL SPACESSPACES

PERITONSILLAR SPACEPERITONSILLAR SPACE

RETROPHARYNGEAL SPACERETROPHARYNGEAL SPACE

PRE VERTEBRAL SPACEPRE VERTEBRAL SPACE

PARAPHARYNGEAL SPACEPARAPHARYNGEAL SPACE

PAROTID SPACEPAROTID SPACE

CAROTID SHEATH SPACECAROTID SHEATH SPACE

VESTIBULAR SPACEVESTIBULAR SPACE

CONCLUSIONCONCLUSION

THANK YOUTHANK YOU