Okoloplodna space


Okoloplodna space (spatium parapharyngeum): 1 - m. masseter; 2 - mandibula; 3 - a. et n. alveolares inf.; 4 - m. pterygoideus; .5 - n. facialis; 6 - glandula parotis; 7-a. carotis ext.; 8 - v. facialis post.; 9 - n. glossopharyngeal 10 and 13 - fascia; 11 - n. accessorius; 12 - a. carotis int. et n. vagus; 14 - gangl. cervicale sup.; 15 - Atlant; 16 - m. longus capitis et colli; 17 - tonsilla palatina.

Okoloplodna space (spatium parapharyngeum) - almost isolated space (Fig.), limited on the inner side of the lateral wall of the pharynx, in front of the ascending part of the lower jaw and internal pterygoid muscle, rear - predposlednee fascia, outside - deep leaf fascia of the parotid gland.
Along this space is under internal carotid artery (a. carotis int.), nerves sublingual, wandering, language-pharyngeal, incremental (nn. hypoglossus, vagus, glossopharyngeus, accessorius), to which the inner side adjoins the internal jugular vein (v. jugularis int.). Through the hole in the deep leaf fascia of the parotid gland okoloplodna space communicates with the internal Department of the bed this gland. Okoloplodna space is connected with zagadochnym space (see). Down O. p. enters the median fissure neck, under the body of the hyoid bone between average and superficial fascia of the neck with one hand and deep fascia neck. At the top of the aperture of the chest median fissure neck goes into the mediastinum.

Acute inflammatory processes in okoloplodna space often run by type of abscesses or cellulitis. They can occur as a result of penetration of virulent infection tonirovannym by, odontogenic, otogenny and from the parotid gland.
With the development okolorotova abscess General condition of the patient suffers dramatically include high fever, sometimes chills, increases leukocytosis and accelerated ROHE. In the result of the inflammatory process in the internal pterygoid muscle may develop long trism lower jaw. During the examination of the throat visible increase and swelling of the tonsils, or sections of the side wall of the throat, swelling of the soft palate. Along with increased painful and regional lymph nodes appear diffuse very tight and painful swelling in the angle of the mandible and on its edge, sometimes passing on the parotid gland. When odontogenic okoloplodna abscess in the first place are the inflammatory changes in the rear of the departments of the alveolar process of the mandible.
Surgical treatment with concomitant administration of antibiotics and sulfonamides. First of all it is necessary to eliminate the hotbed (tonsillectomy when peritonsillar abscess, tooth extraction, trepanation of the mastoid process and other), and then open acropolicy abscess. In very severe condition of the patient may have to first open the abscess. In more complex cases reveal acropolicy abscess or a phlegmon through the neck. To do this, make a cut along the front edge sternoclavicular-liners muscles throughout the upper third of her, starting at 1 cm above the angle of the mandible. Find held together digastric and Shyla-sublingual muscles; the latter pulled down. A blunt instrument, and the best index finger, get over these muscles, soft tissue of the anterior okolorotova space, holding directions upward and slightly to the front, open ulcer and then plugging the wound or give it the rubber drainage; impose several social glue seams.