口腔感染症に対する外科療法

概要

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Most of oral infectious diseases are polymicrobial including anaerobic organisms. Surgical procedure,as well as antibiotics treatment, is necessary especially for patients with severe infection. If proper therapy is not performed, oral infection is still potentially fatal disease.Surgical procedure for severe oral infection requires enough understanding about anatomy of space around the jaws and neck, such as the sublingual space, the submental space, the submandibular space, the buccal space, the masticator space, the parapharyngeal space, the retropharyngeal space, and the retrovisceral space. When the parapharyngeal space is involved, infection often spreads through the retropharyngeal and retrovisceral spaces, and may lead to descending necrotizing mediastinitis.Twenty-two patients with necrotizing fasciitis originated from oral infection were presented. The most frequent cause was infection of the mandibular molar region. Seven of the 22 patients had diabetes mellitus, although 11 had no general diseases. All patients were diagnosed to have necrotizing fasciitis by CT examination on the first day. Extensive debridement was undergone immediately, and all of them obtained good prognosis.
Japanese Society of Oral and Maxillofacial Surgeonsの論文