Masticator space abscess caused by perforation of posterior molar triangle due to chronic denture irritation

• Published in: JOURNAL OF JAPAN SOCIETY FOR HEAD AND NECK SURGERY Vol. 34; no. 3; pp. 259 - 264
• Main Authors: Murase, Erika, Shimizu, Takahiro, Fujimoto, Yasushi
• Format: Journal Article
• Language: Japanese
• Published: JAPAN SOCIETY FOR HEAD AND NECK SURGERY 2025; 特定非営利活動法人 日本頭頸部外科学会
• Subjects: malfunction of the mouth; masticator space abscess; 咀嚼筋間隙膿瘍; 開口障害
• ISSN: 1349-581X; 1884-474X; 1884-474X
• DOI: 10.5106/jjshns.34.259

Odontogenic inflammation tends to spill over into the intermuscular space of mastication and may form abscesses. The patient was an 89-year-old woman who presented with a chief complaint of swelling in the right lower ear and lower jaw. There was a fistula in the mucosa of the right posterior molar triangle of the oral cavity, which was draining. A denture was in contact with the location of the fistula. Contrast-enhanced CT showed an abscess and emphysema in the intermuscular space of the masticatory muscle. It was thought to be a masticatory muscle gap abscess caused by chronic irritation by the denture that perforated the buccal mucosa and triggered infection. In this case, the masticatory muscle pore abscess developed into the submandibular space and the anterior neck. The pathway of the abscess varied, and the patient’s general condition was well maintained due to the anterior extension of the abscess. It is important to understand the pathophysiology based on clinical symptoms and imaging findings.