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Objectives <p>To describe three rare and severe cases of odontogenic phlegmon of the head and neck with atypical spread, emphasizing diagnostic challenges, rapid decision-making and the necessity of multidisciplinary treatment.</p> Materials and Methods <p>We retrospectively reviewed clinical, imaging and surgical data from three patients hospitalized for severe odontogenic infections with uncommon progression patterns at a tertiary maxillofacial surgery center. Risk factors, diagnostic difficulties and management strategies were analyzed.</p> Results <p>Two patients with uncontrolled type 2 diabetes presented with advanced infections complicated by temporal muscle necrosis or descending mediastinitis with pleural empyema and septic shock. A third, otherwise healthy patient developed odontogenic orbital cellulitis. All cases required urgent and staged surgical interventions, broad-spectrum antimicrobial therapy and interdisciplinary collaboration (maxillofacial, thoracic and ophthalmic surgeons, intensivists) to achieve favorable outcomes.</p> Conclusions <p>Atypical spread of odontogenic phlegmon is more severe in patients with chronic systemic diseases such as diabetes. Early imaging-based recognition, aggressive surgical management and strict control of underlying conditions are essential to reduce morbidity and mortality.</p> Clinical Relevance <p>Awareness of atypical infection pathways and multidisciplinary management can improve early recognition and outcomes in complex craniofacial infections.</p>

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Atypical Spread of Head and Neck Phlegmon: Case Series Requiring Multidisciplinary Management

  • 期刊论文

  • 发表日期：

    2026年3月24日

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  • Monika Warlewska,
  • Daria Wziątek-Kuczmik,
  • Jakub Fiegler-Rudol,
  • Iwona Niedzielska

摘要

Objectives

To describe three rare and severe cases of odontogenic phlegmon of the head and neck with atypical spread, emphasizing diagnostic challenges, rapid decision-making and the necessity of multidisciplinary treatment.

Materials and Methods

We retrospectively reviewed clinical, imaging and surgical data from three patients hospitalized for severe odontogenic infections with uncommon progression patterns at a tertiary maxillofacial surgery center. Risk factors, diagnostic difficulties and management strategies were analyzed.

Results

Two patients with uncontrolled type 2 diabetes presented with advanced infections complicated by temporal muscle necrosis or descending mediastinitis with pleural empyema and septic shock. A third, otherwise healthy patient developed odontogenic orbital cellulitis. All cases required urgent and staged surgical interventions, broad-spectrum antimicrobial therapy and interdisciplinary collaboration (maxillofacial, thoracic and ophthalmic surgeons, intensivists) to achieve favorable outcomes.

Conclusions

Atypical spread of odontogenic phlegmon is more severe in patients with chronic systemic diseases such as diabetes. Early imaging-based recognition, aggressive surgical management and strict control of underlying conditions are essential to reduce morbidity and mortality.

Clinical Relevance

Awareness of atypical infection pathways and multidisciplinary management can improve early recognition and outcomes in complex craniofacial infections.