Fascial Spaces

1. SURGICAL FASCIALSURGICAL FASCIAL
SPACESSPACES

2. DefinitionDefinition
 The fascial spaces in head and neck are theThe fascial spaces in head and neck are the
potential spaces between the various layers ofpotential spaces between the various layers of
fascia normally filled with loose connective tissuefascia normally filled with loose connective tissue
(Shapiro) and bounded by anatomical barriers,(Shapiro) and bounded by anatomical barriers,
usually of bone, muscle or fascial layers (Moore).usually of bone, muscle or fascial layers (Moore).

3. FASCIA OF HEAD AND NECKFASCIA OF HEAD AND NECK
 SUPERFICIAL FASCIASUPERFICIAL FASCIA
 DEEP CERVICAL FASCIADEEP CERVICAL FASCIA
A.A. ANTERIOR LAYERANTERIOR LAYER
1. Investing layer1. Investing layer
2. Parotideomesseteric2. Parotideomesseteric
3.Temporal3.Temporal
B. MIDDLE LAYERB. MIDDLE LAYER
1.Sternohyoid-omohyoid division1.Sternohyoid-omohyoid division
2.Sternothyroid-thyrohyoid division2.Sternothyroid-thyrohyoid division
3.Visceral division3.Visceral division
a. Buccopharyngeala. Buccopharyngeal
b. Pretrachealb. Pretracheal
c.Retropharyngealc.Retropharyngeal
C. POSTERIOR LAYERC. POSTERIOR LAYER
a. Alar Divisiona. Alar Division
b. Prevertebral divisionb. Prevertebral division

7. CLASSIFICATION OF FASCIALCLASSIFICATION OF FASCIAL
SPACESSPACES
MODE OF
INVOLVEMENT
1º maxillary
spaces
1º mandibular
spaces
2º fascial
spaces
• Submental
• Submandibular
• Sublingual
• Buccal
• Massetric
• Pterygomandibular
• Sup. & deep temp.
• Lateral pharyngeal
• Retropharyngeal
• Prevertebral
• Parotid space
•Canine
• Buccal
• Infratemporal

8. GRODINKSY & HOLYOKE
Space I Space II Space III Space IV
III IIIA
Space superficial
& deep to platysma
Space behind anterior layer
of deep cervical fascia
Pretracheal
space
Viscero- vascular
space
(Lincoln’s highway
- Mosher)
Danger space –
potential space
between alar &
prevertebral fascia

9. PRIMARY MAXILLARY SPACESPRIMARY MAXILLARY SPACES

10. INFRAORBITAL OF CANINEINFRAORBITAL OF CANINE
SPACESPACE

11. BUCCAL SPACEBUCCAL SPACE

12. INFRATEMPORAL SPACEINFRATEMPORAL SPACE

14. PRIMARY MANDIBULARPRIMARY MANDIBULAR
SPACESSPACES

15. SUBMANDIBULAR SPACESUBMANDIBULAR SPACE

19. SUBLINGUAL SPACESUBLINGUAL SPACE

21. SUBMENTAL SPACESUBMENTAL SPACE

22. MASTICATORY SPACESMASTICATORY SPACES

23. SUB MASSETERIC SPACESUB MASSETERIC SPACE

25. PTERYGOMANDIBULARPTERYGOMANDIBULAR
SPACESPACE

27. SUPERFICIAL TEMPORALSUPERFICIAL TEMPORAL
SPACESPACE

28. SECONDARY FASCIALSECONDARY FASCIAL
SPACESSPACES

29. PERITONSILLAR SPACEPERITONSILLAR SPACE

30. RETROPHARYNGEAL SPACERETROPHARYNGEAL SPACE

33. PRE VERTEBRAL SPACEPRE VERTEBRAL SPACE

34. PARAPHARYNGEAL SPACEPARAPHARYNGEAL SPACE

36. PAROTID SPACEPAROTID SPACE

37. CAROTID SHEATH SPACECAROTID SHEATH SPACE

38. VESTIBULAR SPACEVESTIBULAR SPACE

39. CONCLUSIONCONCLUSION

43. THANK YOUTHANK YOU