Which of the following statements best represent Ludwig's angina?
Ludwig's angina is a rapidly progressive cellulitis of the submandibular space that can cause airway obstruction and death. The submandibular space lies between. The mucous membrane of the floor of mouth and tongue on one side and. The superficial layer of deep cervical fascia extending between the hyoid bone and mandible on the other. The submandibular space is divided into 2 compaments by the mylohyoid muscle. a. Sublingual compament (above the mylohyoid). b. Submaxillary and submental (below the mylohyoid) The two compaments are continuous around the posterior border of the mylohyoid muscle. Aetiology - Dental infections are the most common cause. The infection is most often caused by a virulent Streptococcus (Group A streptococcus are most common) along with anaerobes. Clinical Features Odynophagia (painful swallowing). Trismus (difficulty in the opening mouth). When infection is localized to sublingual space, structures in the floor of the month are swollen and tongue seems to be pushed up and back When the infection spreads to submaxillary space, the submental and submandibular regions become swollen and tender with woody hard feeling. Complications Airway obstruction due to laryngeal oedema, or swelling and push back of the tongue. Spread of infection to parapharyngeal, retropharyngeal spaces and thence to the mediastinum. Aspiration pneumonia. Septicemia. Treatment Consists of giving high doses of broad-spectrum antibiotics, combined with metronidazole to combat the anaerobes immediately until the results of cultures and sensitivity tests are available. In advanced cases when the swelling does not subside rapidly with antibiotics, incision and drainage is advised. Ref : Bailey & Love 24/e p773
A coronary aery spasm
Infection of cellular tissues around submandibular salivary gland
Esophageal spasm
Retropharyngeal infection
Head and neck