Accuracy of Ultrasound in Diagnostics of Odontogenic Infection in Layers of Temporal and Parotid Masseter Region

Abstract

The current study presents the case of a first well described profound ultrasound (US) soft tissues examination in a 65-year-old female with odontogenic phlegmon of the masticator space. Consecutive preoperative clinical images, sonograms and US cine loops in comparison with asymptomatic side are presented and described. Terminology related with head and neck purulent conditions in the area of temporal and a masseter region is fundamentally analyzed.

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“…Although a relatively similar ultrasound picture (Fig 1C ) of the condition was published in another study 22 , in our case, we conducted a more in-depth examination of the sonographic features of the tissues (in particular, the newly formed periosteal reaction). Comparing our case with other published cases of purulent processes in the area of the masseter muscle and their ultrasound descriptions 7,18,19,22,23 , it is worth noting that the described cases demonstrate different ultrasound pattern with limited accumulation of purulent material. The ultrasound images showing the spread of pus between the fibers of the masseter muscle and the minimally invasive treatment presented in this article are unique among other scientific studies.…”

“…Extensive research (2022) based on dissected formaldehyde-fixed human cadaver heads, computed tomography of fresh cadavers, magnetic resonance data, and histological sections has shown all the three masseter muscle layers-superficial, deep, and coronoid 16 . Recently published sonographic studies have highlighted the possibilities of non-radiation imaging for pathologies located in masseter muscle 7,17 . USG proved its usefulness for identifying masseteric area abscesses, phlegmon diagnostics, and drainage of the abscesses 7,16,17 .…”

“…Recently published sonographic studies have highlighted the possibilities of non-radiation imaging for pathologies located in masseter muscle 7,17 . USG proved its usefulness for identifying masseteric area abscesses, phlegmon diagnostics, and drainage of the abscesses 7,16,17 .…”

“…Radiography or computed tomography is typically performed for detailed and appropriate treatment planning in such cases. Considering the growing role and advantages of ultrasonography (USG) in the diagnosis of oral and maxillofacial pathology 4,5 , especially in infection cases [6][7][8] , the application of USG seems to be preferable for the precise localization of pus in osteomyelitis cases.…”

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“…Location of the purulent material in the puscreated subperiosteal space was proved by highresolution USG. Popularity of implementation of the USG into surgical practice continues to grow [11][12][13][14][15] proving its role as a first-line imaging for head and neck pathology. A gray-scale USG in our case also proved its efficacy allowing us to make precise diagnosis which allowed to apply minimally invasive treatment and good outcome.…”