Fascial Space Infections of Head and Neck Region in Nigerians

OBJECTIVE: The head and neck are invested in fascial planes that are normally separated by loose connective tissue. An infection that tracks into the fascial plane destroys the interstitial connective tissue and accumulates as pus or spreads to contiguous tissue space leading to fascial or tissue space abscess or cellulitis. The present study is the first attempt in Nigeria, to review the management of these fairly prevalent and potentially fatal conditions. METHOD: Retrospective study of all patients who presented with fascial space infections between January 1995 and July 2004 at the Maxillofacial Unit of the Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria. RESULT: A total number of 103 patients met the criteria for inclusion in this study. Their age ranged from 1 to 85 years. (mean +SD; 33.5+17.1). They were 55 (53.4%) males and 48 (46.6%) females. Pulpitis was the commonest cause of fascial space infection 43.7%, followed by periodontitis 17.5%. Other aetiological agents were pericoronitis 10.7%, infected extraction socket 9.7%, idiopathic 8.7%, jaw fractures 5.8% and sialadenitis 3.9%. The buccal fascial space was mostly involved 24.3%, followed by the submandibular 23.3%. Most infections (74.8 %) were located in the mandibular region. CONCLUSION: Treatment difficulties and challenges are highlighted and suggestions made on how best to handle them.