man I had the pleasure of having Dr. Al-Shabrawey during dental school at Augusta. the guy is a legend. Now doing my OMFS residency, making me realize how importance his lectures are
You are a great teacher. Your work is going to play a big role is the making of highly knowledgeable physicians and surgeons. My utmost respect to you, sir! 🙏
Really loved your video, thank you. I understand there are many are spaces that are involved that are not discussed here but I really loved the content you delivered and your explanations were great.
Thanks for a very useful video! I have one question though - you draw the alar fascia merging with the deep layer of pre-vertebral fascia at T2 but I thought it merged anteriorly with the buccopharyngeal fascia ending the retropharyngeal space, and the danger space continued down to the level of the diaphragm?
anterior layer of prevertebral fascia is the alar fascia that extends to T3 or T4 and encloses dangerous space between it and the prevertebral fascia. Prevertebral fascia extends from skull base through almost the whole length of vertebral column. this explain in some diseases such as Tuberculosis, infection may extends to the pelvic region and form psoas abscess. I understand there is some confusion and apparent contradiction in the way the attachment of prevertebral fascia is presented in different books. some books referring to the lower attachment to T3 or T4.
Sorry if it was not clear. Once infection spread to buccal space whether from maxillary or mandibular, it could reach to parapharyngeal space. Keep in mind that buccinator is continuous posteriorly with the superior constrictor of pharynx with pterygomandibular ligament inbetween. Best wishes!
@@elghachiai when we are talking about antibiotics we should know the type of bacteria caused the infection this can be achieved by taking a sample of the abcess(usually they are anaerobic bacteria) or by the doctors expirience ..usually they give amoxicilin or penicillin with metronidazole or clyndamycin Even cephalosporins
It is hardly to happen. However, lower teeth infection can indirectly spread to cavernous sinus and from there affecting the eyes. Remember that lower teeth drained by alveolar veins that go back to pterygoid venous plexus which has direct communication with cavernous sinus as well as ophthalmic veins.
@@EasyAnatomy thank you for replying. Ive been having a problem for 6 months now. Started with the feeling of something stuck in my throat. Food was getting stuck like something is blocking it. Then my ears started to feel like they had fluid in them, and i noticed my left tonsil was swollen. Then the left side of my face began to hurt, and to me it looks larger than the other side. I had my tonsols removed as well as my androids. I've had xrays, an mri, a ct scan. They say they see swelling but everything is fine. Ive been to an oral surgeon two times..i have been having pain in a tooth on my left side and sensitivity in my gums. My gums also bleed when i floss between that tooth and another. I saw him the second time a few days ago. He noted swelling and redness but said the tooth looks fine even with all the other symptoms I'm having. I am worried this is going to kill me. Ive been to tons of doctors with this issue and no one has yet to figure it out. Here recently my eye has started to hurt.I'll wake up with gunk in my eye. I went to the eye doctor and told her everything. She told me it was allergies. I have an appointment with an oral surgeon out of town. Hopeful he can help me.
@@amandanichols1988 I'm so sorry to hear about your pain and suffer. As you know there are multiple reasons for orofacial pain. Some of them, present with pain and some are associated with allergy like reaction such as nasal secretion and red eye. Inflammation of tonsils or pharynx (tonsilitis/pharyngitis) refer to ear because of glossopharyngeal nerve that supplies both pharynx and ear drum and may give the feeling of ear fullness. Swelling of face indeed indicates some sort of infection that may arise from maxilla (sinusitis), maxillary teeth or nose. Your symptoms together support the idea of infection. Maxillary sinusitis may give similar symptoms that could be confused with toothache or infection. I'm not sure if you have ever done MRI on maxillary sinus. I think following up with a dentist or Maxillofacial surgeon is good idea. I hope you do ok soon. feel free to contact me anytime.
