What can cause phlegmon of the maxillofacial region?

Any tissue of the human body is capable of responding to irritants with an inflammatory reaction. Often the cause of the development of inflammation are chronic foci of infection. Inflammation of the maxillary region can be represented by phlegmon of the maxillofacial region and provoked by caries or periodontitis.  Phlegmon of the maxillofacial region is an inflammatory process that affects the subcutaneous, submucosal and interfascial tissue in the perimaxillary region. Inflammation has the character of tissue melting, in which healthy tissue is not delimited from damaged tissue.

Causes of development of phlegmon of the maxillofacial region

Phlegmons of the maxillofacial area can be odontogenic and develop due to the penetration of infection through defects in the soft and hard tissues of the tooth, as well as marginal periodontitis. Phlegmon of the maxillary region can develop against the background of osteomyelitis, then it is called odontogenic. In the maxillary zone, an infection can enter through damage to the skin. Furuncles, sialadenitis, pustular diseases and ulcerative stomatitis can contribute to this.

It has been established that streptococci, staphylococci and other anaerobic microorganisms are the causes of perimaxillary phlegmon. The infection enters the deep layers of the skin due to the peculiarities of the outflow of venous blood and lymph. People who are prone to allergic diseases are more susceptible to the development of phlegmon of the maxillofacial region when they get an infection.

Clinical manifestations of phlegmon of the maxillofacial region

The prodromal period lasts for several days. The manifestations of the disease begin acutely. Since healthy and diseased tissue are not separated from each other, the decay products of tissues in the focus of inflammation quickly become the cause of intoxication of the body. Intoxication is manifested by fever, severe weakness, loss of appetite, sleep disturbance and headache.

Externally, the phlegmon of the maxillofacial region looks like a painful diffuse infiltrate, the skin above it is red, swollen and inflamed. If treatment is not started in time, the infiltrate increases in size and becomes denser, and a fluctuation zone is noted in the center. When inflammation is located in the deep layers, local symptoms are not so pronounced.

The main complaints of patients with phlegmon of the maxillofacial area:

• pain when chewing;
• increased salivation when talking or chewing;
• appearance of problems with jaw mobility;
• facial symmetry disorder in the presence of inflammatory infiltrate.

Diagnosis and treatment of phlegmon of the maxillofacial area

Phlegmon of the maxillofacial area carries a certain danger. A complication of phlegmon is thrombosis and asphyxia of the veins of the face with purulent masses. Possible dissemination of infection with the development of meningitis or sepsis. With the development of phlegmon of the maxillofacial region, superficial diagnosis does not require research methods. In this case, the diagnosis is made on the basis of the history and clinical examination. With a deep location of the inflammation, it is advisable to conduct a diagnostic puncture.

It is important to differentiate perimaxillary phlegmon from carbuncles and boils, with inflammation of the salivary glands, and also with erysipelas. In a clinical blood test, changes inherent in purulent inflammation are revealed: leukocytosis, an increased content of neutrophils and an increase in ESR. C-reactive protein is detected in the blood serum.

Treatment of phlegmon of the maxillofacial area in the initial stage consists in the use of conservative methods. If there is a zone of fluctuation, surgical treatment is required, the wound is cleaned, followed by the establishment of drainage. Along with this, antibiotic therapy is prescribed.

With timely treatment, the prognosis is very favorable. It is important to prevent complications of phlegmon of the maxillofacial area.