[Cyanidegypsy]

The operation was done by Prof. Dr. Hekmat Yakoub - Dr.Osama Makkia - Dr Mnyar Ahmad - Dr MaZen Salameh - Dr Ali N Harba - Dr Ahd Makhlof at Tishreen University Hospital Lattakia Syria .......
Submandibular space infection is a rapidly spreading, bilateral, indurated cellulitis occurring in the suprahyoid soft tissues, the floor of the mouth, and both sublingual and submaxillary spaces without abscess formation. Although not a true abscess, it resembles one clinically and is treated similarly.

The condition usually develops from an odontogenic infection, especially of the 2nd and 3rd mandibular molars, or as an extension of peritonsillar cellulitis. Contributing factors may include poor dental hygiene, tooth extractions, and trauma (eg, fractures of the mandible, lacerations of the floor of the mouth).

Symptoms and Signs

Early manifestations are pain in any involved teeth, with severe, tender, localized submental and sublingual induration. Boardlike firmness of the floor of the mouth and brawny induration of the suprahyoid soft tissues may develop rapidly. Drooling, trismus, dysphagia, stridor caused by laryngeal edema, and elevation of the posterior tongue against the palate may be present. Fever, chills, and tachycardia are usually present as well. The condition can cause airway obstruction within hours and does so more often than do other neck infections.

Ludwig Angina
Ludwig Angina
Image provided by Clarence T. Sasaki, MD.
Diagnosis

Clinical evaluation and sometimes CT

The diagnosis usually is obvious. If not, CT is done.

Treatment:
Maintenance of airway patency

Surgical incision and drainage

Antibiotics active against oral flora

Maintaining airway patency is of the highest priority. Because swelling makes oral endotracheal intubation difficult, fiberoptic nasotracheal intubation done with topical anesthesia in the operating room or ICU with the patient awake is preferable. Some patients require a tracheotomy. Patients without immediate need for intubation require intense observation and may benefit temporarily from a nasal trumpet.

Incision and drainage with placement of drains deep into the mylohyoid muscles relieve the pressure. Antibiotics should be chosen to cover both oral anaerobes and aerobes (eg, clindamycin, ampicillin/sulbactam, high-dose penicillin).

[NAV3]

Apparently one of the doctors is hoping that it's filled with lobster.

[Davis916]

I can tell you that the smell in the room was not so nice after they opened that Abscess. Decomp would be better than that stench.

[BrianBear5150]

How foul!

[vagabond]

They weren't ready for that gusher!

[~Undertow~]

Did the doc on the left slap the hand of the doc on the right? At about the 1:25 mark.... Lol

[pain4anangel]

Originally Posted by ~Undertow~ ↗

Did the doc on the left slap the hand of the doc on the right? At about the 1:25 mark.... Lol

I was just about to comment on that hahaha!

"I'm thinking we should cut it like this..."
"Cut it this way..."
"See? THIS way!"
"Got it? This way! Across like THIS."
Guy goes to cut and the doctor smacks his hand.
"No, you stupid fuck, just let me do it..."


And do they not have a kidney bowl anywhere in the office/hospital? Poor girl.

[Azimuth]

It was fine to watch until doctor started digging around in there with his finger.

[durt]

Originally Posted by Azimuth ↗

It was fine to watch until doctor started digging around in there with his finger.

Looked like there was some messy, learning exploration going on there

[Keydog]

Love the soundtrack, that's some sentimental shit