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Masticator Space Abscess
Bronwyn E. Hamilton, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Definitions

              • Masticator space (MS) abscess: Abscess within MS usually arises from molar tooth (odontogenic) infection or following dental procedure

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Nuclear Medicine Findings

                    • Dental X-Ray or Panorex

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Bottini GB et al: Compartment syndrome of the temporal muscle. J Craniofac Surg. 31(2):e135-7, 2020
                                            2. Chughtai S et al: Radiographic review of anatomy and pathology of the masticator space: what the emergency radiologist needs to know. Emerg Radiol. 27(3):329-39, 2020
                                            3. Newsome HA et al: Odontogenic sinusitis: current concepts in diagnosis and treatment. Immunol Allergy Clin North Am. 40(2):361-9, 2020
                                            4. Santos FV et al: Deep neck space infection and Lemierre's syndrome caused by Streptococcus anginosus: a case report. IDCases. 19:e00669, 2020
                                            5. Blanchard A et al: An unusual fungal infection in the masticator space with intracranial extension in an immunocompromised patient. Ear Nose Throat J. 98(4):201-2, 2019
                                            6. Feldhaus F et al: Metallic dental artifact reduction in computed tomography (Smart MAR): improvement of image quality and diagnostic confidence in patients with suspected head and neck pathology and oral implants. Eur J Radiol. 118:153-60, 2019
                                            7. Pesis M et al: Deep neck infections are life threatening infections of dental origin: a presentation and management of selected cases. Isr Med Assoc J. 12(21):806-11, 2019
                                            8. Smith R et al: Masticator space abscess arising from a spontaneous external auditory canal cholesteatoma. Otol Neurotol. 38(4):e17-e18, 2017
                                            9. Kos M: Incidence and risk predictors for osteonecrosis of the jaw in cancer patients treated with intravenous bisphosphonates. Arch Med Sci. 11(2):319-24, 2015
                                            10. Lin RH et al: Correlation between imaging characteristics and microbiology in patients with deep neck infections: a retrospective review of one hundred sixty-one cases. Surg Infect (Larchmt). 15(6):794-9, 2014
                                            11. Wabik A et al: Odontogenic inflammatory processes of head and neck in computed tomography examinations. Pol J Radiol. 79:431-8, 2014
                                            12. Hamilton JD et al: Superimposed infection in mandibular osteoradionecrosis: diagnosis and outcomes. J Comput Assist Tomogr. 36(6):725-31, 2012
                                            13. Faye N et al: The masticator space: from anatomy to pathology. J Neuroradiol. 36(3):121-30, 2009
                                            14. Sakamoto H et al: A case of brain abscess extended from deep fascial space infection. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 108(3):e21-5, 2009
                                            15. Hasegawa T et al: Two cases of masticator space abscess initially diagnosed as temporomandibular joint disorder. Kobe J Med Sci. 54(3):E163-8, 2008
                                            16. Schuknecht B et al: Masticator space abscess derived from odontogenic infection: imaging manifestation and pathways of extension depicted by CT and MR in 30 patients. Eur Radiol. 18(9):1972-9, 2008
                                            17. Phal PM et al: Imaging findings of bisphosphonate-associated osteonecrosis of the jaws. AJNR Am J Neuroradiol. 28(6):1139-45, 2007
                                            18. Jones KC et al: Chronic submasseteric abscess: anatomic, radiologic, and pathologic features. AJNR Am J Neuroradiol. 24(6):1159-63, 2003
                                            19. McClay JE et al: Intravenous antibiotic therapy for deep neck abscesses defined by computed tomography. Arch Otolaryngol Head Neck Surg. 129(11):1207-12, 2003
                                            20. Bratton TA et al: Management of complex multi-space odontogenic infections. J Tenn Dent Assoc. 82(3):39-47, 2002
                                            21. Plaza Mayor G et al: Is conservative treatment of deep neck space infections appropriate? Head Neck. 23(2):126-33, 2001
                                            22. Yuan WH et al: Image evaluation of suprazygomatic masticator space lesions. Kaohsiung J Med Sci. 17(3):139-49, 2001
                                            23. Sivarajasingam V et al: Ultrasound-guided needle aspiration of lateral masticator space abscess. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 88(5):616-9, 1999
                                            24. Yonetsu K et al: Deep facial infections of odontogenic origin: CT assessment of pathways of space involvement. AJNR Am J Neuroradiol. 19(1):123-8, 1998
                                            25. Ginsberg LE: Inflammatory and infectious lesions of the neck. Semin Ultrasound CT MR. 18(3):205-19, 1997
                                            26. Kim HJ et al: Odontogenic versus nonodontogenic deep neck space infections: CT manifestations. J Comput Assist Tomogr. 21(2):202-8, 1997
                                            27. Chong VF et al: Pictorial review: radiology of the masticator space. Clin Radiol. 51(7):457-65, 1996
                                            28. Tryhus MR et al: The normal and diseased masticator space. Semin Ultrasound CT MR. 11(6):476-85, 1990
                                            29. Curtin HD: Separation of the masticator space from the parapharyngeal space. Radiology. 163(1):195-204, 1987
                                            30. Doxey GP et al: The masticator space: the influence of CT scanning on therapy. Laryngoscope. 95(12):1444-7, 1985
                                            31. Hardin CW et al: Infection and tumor of the masticator space: CT evaluation. Radiology. 157(2):413-7, 1985
                                            32. Nyberg DA et al: Computed tomography of cervical infections. J Comput Assist Tomogr. 9(2):288-96, 1985
                                            33. Braun IF et al: Computed tomography of the buccomasseteric region: 2. Pathology. AJNR Am J Neuroradiol. 5(5):611-6, 1984
                                            34. Calcaterra VE et al: Infections of the masseteric space in children. Otolaryngol Head Neck Surg. 92(1):118-22, 1984
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Clinical Issues

                                                    • Diagnostic Checklist

                                                      TERMINOLOGY

                                                      • Definitions

                                                        • Masticator space (MS) abscess: Abscess within MS usually arises from molar tooth (odontogenic) infection or following dental procedure

                                                      IMAGING

                                                      • General Features

                                                        • CT Findings

                                                          • MR Findings

                                                            • Nuclear Medicine Findings

                                                              • Dental X-Ray or Panorex

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Bottini GB et al: Compartment syndrome of the temporal muscle. J Craniofac Surg. 31(2):e135-7, 2020
                                                                                      2. Chughtai S et al: Radiographic review of anatomy and pathology of the masticator space: what the emergency radiologist needs to know. Emerg Radiol. 27(3):329-39, 2020
                                                                                      3. Newsome HA et al: Odontogenic sinusitis: current concepts in diagnosis and treatment. Immunol Allergy Clin North Am. 40(2):361-9, 2020
                                                                                      4. Santos FV et al: Deep neck space infection and Lemierre's syndrome caused by Streptococcus anginosus: a case report. IDCases. 19:e00669, 2020
                                                                                      5. Blanchard A et al: An unusual fungal infection in the masticator space with intracranial extension in an immunocompromised patient. Ear Nose Throat J. 98(4):201-2, 2019
                                                                                      6. Feldhaus F et al: Metallic dental artifact reduction in computed tomography (Smart MAR): improvement of image quality and diagnostic confidence in patients with suspected head and neck pathology and oral implants. Eur J Radiol. 118:153-60, 2019
                                                                                      7. Pesis M et al: Deep neck infections are life threatening infections of dental origin: a presentation and management of selected cases. Isr Med Assoc J. 12(21):806-11, 2019
                                                                                      8. Smith R et al: Masticator space abscess arising from a spontaneous external auditory canal cholesteatoma. Otol Neurotol. 38(4):e17-e18, 2017
                                                                                      9. Kos M: Incidence and risk predictors for osteonecrosis of the jaw in cancer patients treated with intravenous bisphosphonates. Arch Med Sci. 11(2):319-24, 2015
                                                                                      10. Lin RH et al: Correlation between imaging characteristics and microbiology in patients with deep neck infections: a retrospective review of one hundred sixty-one cases. Surg Infect (Larchmt). 15(6):794-9, 2014
                                                                                      11. Wabik A et al: Odontogenic inflammatory processes of head and neck in computed tomography examinations. Pol J Radiol. 79:431-8, 2014
                                                                                      12. Hamilton JD et al: Superimposed infection in mandibular osteoradionecrosis: diagnosis and outcomes. J Comput Assist Tomogr. 36(6):725-31, 2012
                                                                                      13. Faye N et al: The masticator space: from anatomy to pathology. J Neuroradiol. 36(3):121-30, 2009
                                                                                      14. Sakamoto H et al: A case of brain abscess extended from deep fascial space infection. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 108(3):e21-5, 2009
                                                                                      15. Hasegawa T et al: Two cases of masticator space abscess initially diagnosed as temporomandibular joint disorder. Kobe J Med Sci. 54(3):E163-8, 2008
                                                                                      16. Schuknecht B et al: Masticator space abscess derived from odontogenic infection: imaging manifestation and pathways of extension depicted by CT and MR in 30 patients. Eur Radiol. 18(9):1972-9, 2008
                                                                                      17. Phal PM et al: Imaging findings of bisphosphonate-associated osteonecrosis of the jaws. AJNR Am J Neuroradiol. 28(6):1139-45, 2007
                                                                                      18. Jones KC et al: Chronic submasseteric abscess: anatomic, radiologic, and pathologic features. AJNR Am J Neuroradiol. 24(6):1159-63, 2003
                                                                                      19. McClay JE et al: Intravenous antibiotic therapy for deep neck abscesses defined by computed tomography. Arch Otolaryngol Head Neck Surg. 129(11):1207-12, 2003
                                                                                      20. Bratton TA et al: Management of complex multi-space odontogenic infections. J Tenn Dent Assoc. 82(3):39-47, 2002
                                                                                      21. Plaza Mayor G et al: Is conservative treatment of deep neck space infections appropriate? Head Neck. 23(2):126-33, 2001
                                                                                      22. Yuan WH et al: Image evaluation of suprazygomatic masticator space lesions. Kaohsiung J Med Sci. 17(3):139-49, 2001
                                                                                      23. Sivarajasingam V et al: Ultrasound-guided needle aspiration of lateral masticator space abscess. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 88(5):616-9, 1999
                                                                                      24. Yonetsu K et al: Deep facial infections of odontogenic origin: CT assessment of pathways of space involvement. AJNR Am J Neuroradiol. 19(1):123-8, 1998
                                                                                      25. Ginsberg LE: Inflammatory and infectious lesions of the neck. Semin Ultrasound CT MR. 18(3):205-19, 1997
                                                                                      26. Kim HJ et al: Odontogenic versus nonodontogenic deep neck space infections: CT manifestations. J Comput Assist Tomogr. 21(2):202-8, 1997
                                                                                      27. Chong VF et al: Pictorial review: radiology of the masticator space. Clin Radiol. 51(7):457-65, 1996
                                                                                      28. Tryhus MR et al: The normal and diseased masticator space. Semin Ultrasound CT MR. 11(6):476-85, 1990
                                                                                      29. Curtin HD: Separation of the masticator space from the parapharyngeal space. Radiology. 163(1):195-204, 1987
                                                                                      30. Doxey GP et al: The masticator space: the influence of CT scanning on therapy. Laryngoscope. 95(12):1444-7, 1985
                                                                                      31. Hardin CW et al: Infection and tumor of the masticator space: CT evaluation. Radiology. 157(2):413-7, 1985
                                                                                      32. Nyberg DA et al: Computed tomography of cervical infections. J Comput Assist Tomogr. 9(2):288-96, 1985
                                                                                      33. Braun IF et al: Computed tomography of the buccomasseteric region: 2. Pathology. AJNR Am J Neuroradiol. 5(5):611-6, 1984
                                                                                      34. Calcaterra VE et al: Infections of the masseteric space in children. Otolaryngol Head Neck Surg. 92(1):118-22, 1984