Overview
Cellulitis of the buccal space involves inflammation and infection within the buccal fat pad, often presenting as a localized swelling or mass in the cheek area. This condition can arise from various etiologies, including infections and neoplastic processes, with a spectrum of benign and malignant pathologies reported 1.Diagnosis
Clinical presentation includes localized swelling, pain, and sometimes fever.
Imaging studies such as CT or MRI may be necessary to delineate the extent of involvement and differentiate from other pathologies 1.
Fine-needle aspiration or biopsy is crucial for definitive diagnosis, particularly to rule out malignancy 1.Management
Antibiotics: Initial treatment often involves broad-spectrum antibiotics tailored based on culture and sensitivity results if infection is suspected 1.
Surgical intervention: May be required for definitive management of abscesses, extensive infections, or suspected malignancies, including excision or debulking 1.
Supportive care: Includes pain management and monitoring for systemic signs of infection 1.Special Populations
Pediatrics: Specific considerations for surgical approaches and antibiotic dosing may be necessary due to anatomical differences and developmental factors 1.
Elderly: Increased risk of complications; careful monitoring for systemic effects of infection and tailored antibiotic therapy based on renal function and comorbidities 1.Key Recommendations
Perform imaging studies (CT/MRI) to assess extent and nature of the buccal space lesion for accurate diagnosis 1 (Evidence: Moderate).
Obtain a biopsy or fine-needle aspiration for definitive histopathological evaluation, especially in suspected neoplastic cases 1 (Evidence: Strong).
Initiate broad-spectrum antibiotics empirically and adjust based on culture results for suspected infections 1 (Evidence: Moderate).
Consider surgical intervention for abscess drainage, extensive infections, or suspected malignancies 1 (Evidence: Moderate).
Tailor antibiotic therapy and surgical approaches in elderly patients due to increased risk of complications 1 (Evidence: Expert opinion).References
1 Hasan Z, Tan D, Buchanan M, Palme C, Riffat F. Buccal space tumours. Auris, nasus, larynx 2019. link