Definition — Buccal Space Cellulitis: Buccal space cellulitis is an acute bacterial infection of the buccal soft tissues, usually originating from odontogenic sources, trauma, or adjacent soft tissue infection. It is characterized by diffuse inflammation, soft tissue edema, and pain. Early diagnosis is crucial to prevent abscess formation or spread into deep fascial spaces.
Ultrasound report- line The buccal space reveals diffuse ill-defined hyperechoic changes of the subcutaneous fat with increased echogenicity and thickening of the overlying soft tissues. There is loss of normal fascial plane differentiation with evidence of edema extending into the buccal fat pad. No well-formed fluid collection or drainable abscess is seen. Color Doppler demonstrates increased vascularity consistent with inflammatory hyperemia.
Cnclusion: Findings are consistent with buccal space cellulitis, characterized by diffuse soft tissue edema and inflammatory changes without evidence of a well-defined abscess/collection
Recommendation: Recommend clinical correlation and appropriate medical management Follow-up ultrasound may be performed if symptoms persist or worsen.
Sonographic Features — Buccal Space Cellulitis:
- Soft tissue echotexture: Ill-defined hyperechoic subcutaneous fat with loss of fascial plane clarity.
- Edema: Hypoechoic streaky areas within buccal fat pad and subcutaneous tissues.
- Wall thickening: Diffuse thickening of overlying soft tissues and skin.
- Vascularity: Increased color Doppler vascularity due to inflammatory hyperemia.
- Abscess formation (if present): Focal hypoechoic/anechoic collection with internal echoes and peripheral vascularity.
Ultrasound Examination:
High-frequency (7–12 MHz) linear probe used over buccal region.
- Diffuse ill-defined hyperechoic changes in subcutaneous tissue with hypoechoic streaks.
- Loss of fascial plane differentiation between buccal fat pad and adjacent soft tissue.
- Overlying skin and soft tissue thickening with increased vascularity on Doppler.
- No discrete drainable abscess identified.
Causes / Etiology — Buccal Space Cellulitis:
- Odontogenic infection (most common — molar/periapical abscess).
- Post-traumatic soft tissue infection.
- Spread from adjacent facial or submandibular infection.
- Systemic immunocompromised states (e.g., diabetes).
Symptoms / Clinical Features — Buccal Space Cellulitis:
- Cheek swelling, pain, and tenderness.
- Erythema, warmth, and induration of buccal tissues.
- Fever, malaise, leukocytosis.
- May progress to abscess if untreated.
Diagnostic Strategy — Buccal Space Cellulitis:
- Ultrasound: First-line imaging to detect cellulitis and early abscess.
- CT/MRI: Used for deep space involvement or when abscess suspected.
- Differential: Abscess, infected cyst, neoplasm, hematoma.
Declaration:
I, R. K. Mouj, hereby declare that the material presented in this document titled "Buccal Space Cellulitis: Definition, Sonographic Features, Case Studies, and Risk Assessment" has been prepared and compiled by me for educational purposes only. It is intended for learning, training, and academic reference. Sources and references have been acknowledged where appropriate.
Ethics / Patient Data Statement: Any patient images, case material, or ultrasound examples included here are for academic use only, anonymised, and used with ethical consideration.
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