Learning objectives
To review the anatomy of the massetric space as a subsection of the masticator spaceTo illustrate the range of pathology that can affect this region, highlighting the similarities and differences from pathologies affecting the masticator space in generalWe aim to increase awareness of both real and pseudo lesions of this anatomical area with a view to aiding the reporting radiologist in their recognition and assessment
Background
AnatomyThe masticator space is bounded by the buccal space and maxillary antra anteriorly, by the parapharyngeal space postero-medially and the ramus of the mandible and masseter muscle and parotid space posteriorly [1].It contains the muscles of mastication – the temporalis, medial and lateral pterygoid muscles and the masseter.The space is bounded by the superficial layer of the deep cervical fascia; medially this extends up to the skull base and foramen ovale separating the masticator from the parapharyngeal space, laterally it is adherent to the posterior...
Imaging findings OR Procedure details
Imaging findings
Pseudo lesions
Gum chewing or teeth grinding – particularly at night (bruxism) can lead to asymmetric hypertrophy of the masseter and other muscles of mastication giving the appearance of an asymmetric mass in the masseteric space (Fig 1). Normalmeasurements have been established for masseteric volume which can be used to define abnormal enlargement as a cause for facial asymmetry/apparent mass [5,6].In the same way that benign hypertrophy can mimic a mass lesion the development of asymmetric atrophy of masticatory muscles can prompt the...
Conclusion
The masseteric space has been defined as a sub-section of the masticator space.Some pathologies – particularly those of dental origin, accessory parotid tissue and masseteric hypertrophy are specific to the masseteric rather than masticator space.This part of the masticator space is still susceptible to the broad range of inflammatory and malignant pathologies that affect the masticator space and other deep head and neck spaces.Knowledge of both the specific and general pathologies that affect this part of the masticator space will help the reporting radiologist to...
Personal Information
Dr A Thomas and Dr MA Syed - Radiology Specialty Registrars in Clinical Radiologyat the University Hospitals of Leicester, Leicester, UK.Contact:
[email protected] R Vaidhyanath, Consultant Radiologist, University Hospitals of Leicester, Leicester, UK
References
Chong VFH, Fan YF. Pictorial review: Radiology of the Masticator Space. Clin Rad 1996; 51:457-465.Extracranial head and neck. In Applied Radiological Anatomy, Butler P, Mitchell AWM and Ellis H (Ed). Cambridge University Press, Cambridge, 1999.Schuknecht B, Stergiou G, Graetz K. Masticator space abscess derived from odontogenic infection: imaging manifestation and pathways of extension depicted by CT and MR in 30 patients. Eur Radiol 2008; 18: 1972 – 1979.Bransby-Zachary GM. The sub-masseteric space. Br Dent J 1948; 84: 10-13.Xu JA, Yuasa K, Yoshiura K, Kanda S....