Head and Neck Imaging

Masticator space, pathology

A lesion within the masticator space is usually sited in the ascending ramus or angle of the mandible, or within the masticatory muscles; the lesion is anterolateral to the parapharyngeal space . Trismus (masticatory muscle spasm causing inability to open the mouth) is a common symptom in masticator space pathology, restricting the clinician's examination of this area, and making the imaging findings of major importance.
Common lesions include:
- abscess, usually of dental origin (Fig. 1); this may be accompanied by mandibular osteomyelitis (see also abscess, dental ).
- squamous cell carcinoma, head and neck , either by direct invasion from the oropharynx (see oropharyngeal cancer ) or from the retromolar trigone, pathology , or by perineural tumour spread, head and neck along the inferior alveolar nerve and mandibular nerve.
- sarcoma, of either muscular or bony origin (see chondrosarcoma, head and neck , osteosarcoma, head and neck , rhabdomyosarcoma, head and neck ). (Fig. 2)
- non-Hodgkin lymphoma, head and neck manifestation ( non-Hodgkin lymphoma, head and neck manifestation ).

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Fig. 01a

Axial contrast-enhanced CT images showing abscess formation in the left masticator space (a, arrow), originating from a dental (molar) abscess (b, bone window, arrowhead). The abscess spreads along the mandible to the left submandibular space (c) and submental space (d), spreading again superiorly into the right submandibular space (arrowhead in c), causing cellulitis in the right parapharyngeal space (arrowhead in a).
Masticator space, pathology, Fig. 01a (a)
Masticator space, pathology, Fig. 01b (b)
Masticator space, pathology, Fig. 01c (c)
Masticator space, pathology, Fig. 01d (d)
Masticator space, pathology, Fig. 02a (a)
Masticator space, pathology, Fig. 02b (b)
Masticator space, pathology, Fig. 02c (c)