Cavernous sinus thrombosis complicating odontogenic parapharyngeal space neck abscess: A case report and discussion

Sudden onset proptosis secondary to cavernous sinus thrombosis from underlying mandibular dental infection

“…A literature search revealed that most cases of odontogenic septic CST cite a maxillary origin. Aside from our case, we were only able to find two other cases that claim a mandibular dental nidus 4 , 5. Our case is unusual in this respect and in its complication by proptosis, distal infective emboli causing lung abscesses and middle cerebral artery thrombosis.…”

“…In our patient, we postulate that such spread occurred via the retromandibular vein and the pterygoid plexus, culminating in CST and superior ophthalmic vein thrombosis (with later middle cerebral artery thrombosis). Other suggested routes of spread in mandibular infections causing CST include direct spread to the pterygoid plexus from the alveolar ridge and spread to the carotid sheath via the parapharyngeal space 4 , 5. Superior ophthalmic vein thrombosis has also been documented in relation to maxillary dental infections 7.…”

“…Staphylococcus aureus is the causative agent in more than half of septic CST cases,4 , 12 , 13 most of which arise from sphenoidal and ethmoidal sinus infections 10 , 13. Mixed organisms are usually found in odontogenic sources and these include streptococci (notably of the β haemolytic variety) and anaerobes 8 , 14.…”

A five-year retrospective study of odontogenic maxillofacial infections in a large urban public hospital

“…They are more common in under-served patients lacking access to health care, who often obtain their health care through the Emergency Room of publicly funded hospitals. These infections generally respond to antimicrobial chemotherapy and/or surgical intervention 6,12 , but there are numerous published reports of odontogenic infections spreading to the cavernous sinus, deep musculofascial spaces and other vital structures 1,2,5,[7][8][9][10]13,[15][16][17][18] . They can lead to airway compromise, involvement of the mediastinum and septicemia.…”

Bilateral cavernous sinus thrombosis and facial palsy as complications of dental abscess

“…In 2000, Feldman et al ,[6] reported a case of 69-year-old male who was being treated for dental abscess. Computed tomography of brain did not show any intracranial abnormalities at the time of admission, but there was presence of a right parapharyngeal abscess.…”