eRadiograph Volume 7: Imaging of Oral Cavity | Page 142

Head and neck lesions are very challenging due to the complex anatomy and wide
ranging pathology that is present in the head and neck region. The neck is divided into
functional spaces by the superficial and deep layers of the fascia. Each of these fascial
spaces contains specific anatomical structures. This helps in determining the
differential diagnosis of pathological processes in the neck. Once the neck space is
localised, based on the anatomical contents the possible pathologies arising from
those anatomical contents can be evaluated, if specific imaging features are available a
specific diagnosis may be made. Additionally the fascia act as barriers to spread of
disease however when breached the disease spreads along specific anatomical planes
in the face, neck as well as to the mediastinum. Thus location of a lesion is very
important as it helps determine pathology as well as possible routes of spread of
disease.

Introduction

The fascia of the neck are the superficial and deep layers. The deep layer is further
divided into three layers a superficial middle and deep.The superficial layer of the deep
fascia encloses the Masticator, Parotid, Submandibular and sublingual spaces. The
middle layer of the deep fascia encloses the Pharyngeal mucosal space, Visceral,
Retropharyngeal and buccal spaces. The deep layer of deep fascia surrounds the peri
and paravertebral spaces. The carotid space is invested by all three layers of the deep
cervical fascia.  A simpler classification is to consider the spaces as supra hyoid and
infra hyoid. The supra hyoid spaces are- Pharyngeal mucosal, parapharyngeal,
M asticator, Buccal, Parotid, Carotid, Retropharyngeal,Sublingual, sub mandibular, Peri
and paravertebral. Infrahyoid neck-Carotid, Visceral, Retropharyngeal, Peri and
paravertebral.

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