Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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An unusual abscess formation in the masticator space after acupressure massage: a case report

  • Ko, In-Chan (Department of Oral and Maxillofacial Surgery, Inje University Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Yoon, Kyu-Ho (Department of Oral and Maxillofacial Surgery, Inje University Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Park, Kwan-Soo (Department of Oral and Maxillofacial Surgery, Inje University Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Cheong, Jeong-Kwon (Department of Oral and Maxillofacial Surgery, Inje University Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Bae, Jung-Ho (Department of Oral and Maxillofacial Surgery, Inje University Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Lee, Kwon-Woo (Department of Oral and Maxillofacial Surgery, Inje University Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Chin, Young-Jai (Department of Oral and Maxillofacial Surgery, Inje University Sanggye Paik Hospital, Inje University College of Medicine)
  • Received : 2014.09.02
  • Accepted : 2014.10.17
  • Published : 2015.02.28
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Abstract

Clinical features of masticator-space abscess (MSA) are very similar to those of parotitis or temporomandibular disorder (TMD), making early differential diagnosis difficult. Local causes of MSA include nerve block anesthesia, infection after tooth extraction, and trauma to the temporomandibular joint (TMJ); the systemic cause is immunodeficiency. Odontogenic causes account for most etiologies, but there are also unusual causes of MSA. A 66-year-old male patient visited the emergency room (ER) presenting with left-side TMJ pain three days after receiving an acupressure massage. He was tentatively diagnosed with conventional post-trauma TMD and discharged with medication. However, the patient returned to the ER with increased pain. At this time, his TMD diagnosis was confirmed. He made a third visit to the ER during which facial computed tomographic (CT) images were taken. CT readings identified an abscess or hematoma in the left masticator space. After hospitalizing the patient, needle aspiration confirmed pus in the infratemporal and temporal fossa. Antibiotics were administered, and the abscess was drained through an incision made by the attending physician. The patient's symptoms decreased, and he was discharged.

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