📘 Space Infections – MCQs & Important note

 1. Which of the following is most commonly involved in Ludwig’s angina?

A. Submandibular space

B. Sublingual space

C. Buccal space

D. Parapharyngeal space

👉 Answer: A. Submandibular space

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2. The most serious complication of Ludwig’s angina is:

A. Facial cellulitis

B. Orbital cellulitis

C. Airway obstruction

D. Osteomyelitis

👉 Answer: C. Airway obstruction

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3. Which fascial space is most commonly involved in infections from mandibular third molar?

A. Buccal space

B. Submasseteric space

C. Submandibular space

D. Canine space

👉 Answer: C. Submandibular space

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4. The "danger space" in neck infections refers to the space between:

A. Buccinator and masseter

B. Prevertebral and alar fascia

C. Platysma and superficial fascia

D. Pretracheal and prevertebral fascia

👉 Answer: B. Prevertebral and alar fascia

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5. Canine space infection most commonly originates from:

A. Maxillary third molar

B. Mandibular first molar

C. Maxillary canine

D. Mandibular premolar

👉 Answer: C. Maxillary canine

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6. A swelling below the eye with obliteration of nasolabial fold is most likely due to infection of:

A. Buccal space

B. Submental space

C. Canine space

D. Infratemporal space

👉 Answer: C. Canine space

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7. The first line of treatment for a space infection is:

A. Hospitalization and observation

B. IV antibiotics and surgical drainage

C. Oral antibiotics only

D. Immediate extraction of the offending tooth

👉 Answer: B. IV antibiotics and surgical drainage

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8. Which of the following is a sign of cavernous sinus thrombosis from maxillofacial infection?

A. Bilateral periorbital edema

B. Trismus

C. Facial asymmetry

D. Submandibular swelling

👉 Answer: A. Bilateral periorbital edema

Here is a concise and important revision note on Space Infections in Oral and Maxillofacial Surgery (OMS) for competitive exams:

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✅ Important Notes on Space Infections (OMS)

🔹 Common Causes

Odontogenic infections (especially from molars)

Post-extraction infections

Pericoronitis (especially lower third molar)

Trauma, salivary gland infection, systemic immunocompromised state

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🔹 Important Fascial Spaces

Space Common Source Clinical Sign

Buccal Upper molars Cheek swelling, spares eye

Canine Maxillary canine Swelling below eye, obliteration of nasolabial fold

Submandibular Lower molars (esp. 2nd & 3rd) Swelling under mandible, trismus

Sublingual Premolars/molars Raised floor of mouth, tongue elevation

Submental Anterior mandibular teeth Swelling under chin

Masticator space 3rd molars Trismus, swelling around ramus

Parapharyngeal Tonsil infections Dysphagia, lateral pharyngeal swelling

Retropharyngeal Tonsils/nasopharynx Dysphagia, airway compromise

Danger space Extension of deep infection High mortality – may spread to mediastinum

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🔹 Ludwig’s Angina

Definition: Rapidly spreading bilateral infection of submandibular, sublingual, and submental spaces.

Cause: Typically mandibular molars.

Signs: Brawny indurated floor of mouth, trismus, dysphagia, tongue elevation, potential airway obstruction.

Emergency: Requires airway management, IV antibiotics, and surgical drainage.

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🔹 Red Flags (Life-threatening Complications)

Airway compromise

Cavernous sinus thrombosis (from facial/dental infections)

Sepsis

Mediastinitis (from deep neck space infections)

Necrotizing fasciitis

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🔹 Management Summary

1. Identify the source (clinical + radiograph/CT)

2. Remove cause (tooth extraction/root canal)

3. Incision and drainage if fluctuant swelling

4. Broad-spectrum IV antibiotics (e.g. Amoxicillin-clavulanate + Metronidazole)

5. Airway monitoring/support in deep neck or Ludwig's infections

6. Culture and sensitivity test if infection persists

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Let me know if you want a one-page PDF version or a visual diagram for quick recall.