The submental space is a fascial space of the head and neck (sometimes also termed

fascia A fascia (; plural fasciae or fascias; adjective fascial; from Latin: "band") is a band or sheet of connective tissue, primarily collagen, beneath the skin that attaches to, stabilizes, encloses, and separates muscles and other internal organ ...

l spaces or tissue spaces). It is a

potential space In anatomy, a potential space is a space between two adjacent structures that are normally pressed together (directly apposed). Many anatomic spaces are potential spaces, which means that they are potential rather than realized (with their realiz ...

located between the

mylohyoid muscle The mylohyoid muscle or diaphragma oris is a paired muscle of the neck. It runs from the mandible to the hyoid bone, forming the floor of the oral cavity of the mouth. It is named after its two attachments near the molar teeth. It forms the floor ...

superior Superior may refer to: *Superior (hierarchy), something which is higher in a hierarchical structure of any kind Places * Superior (proposed U.S. state), an unsuccessful proposal for the Upper Peninsula of Michigan to form a separate state *Lak ...

ly, the

platysma muscle The platysma muscle is a superficial muscle of the human neck that overlaps the sternocleidomastoid. It covers the anterior surface of the neck superficially. When it contracts, it produces a slight wrinkling of the neck, and a "bowstring" effe ...

inferior Inferior may refer to: * Inferiority complex * An Anatomical terms of location#Superior and inferior, anatomical term of location * Inferior angle of the scapula, in the human skeleton *Inferior (book), ''Inferior'' (book), by Angela Saini * ''The ...

ly, under the chin in the midline. The space coincides with the

anatomic Anatomy () is the branch of biology concerned with the study of the structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old science, having it ...

region termed the

submental triangle The submental triangle (or suprahyoid triangle) is a division of the anterior triangle of the neck. Boundaries It is limited to: * Lateral (away from the midline), formed by the anterior belly of the digastricus * Medial (towards the midline), ...

, part of the

anterior triangle of the neck The anterior triangle is a region of the neck. Structure The triangle is inverted with its apex inferior to its base which is under the chin. Investing fascia covers the roof of the triangle while visceral fascia covers the floor. Anatomy Mus ...

Location and structure

Anatomic boundaries

The boundaries of the submental space are: * the mylohyoid muscle superiorly * the investing layer of deep cervical fascia (and this in turn is covered by the platysma muscle) inferiorly * the inferior border of the

mandible In anatomy, the mandible, lower jaw or jawbone is the largest, strongest and lowest bone in the human facial skeleton. It forms the lower jaw and holds the lower teeth in place. The mandible sits beneath the maxilla. It is the only movable bon ...

anterior Standard anatomical terms of location are used to unambiguously describe the anatomy of animals, including humans. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position prov ...

ly * the

hyoid bone The hyoid bone (lingual bone or tongue-bone) () is a horseshoe-shaped bone situated in the anterior midline of the neck between the chin and the thyroid cartilage. At rest, it lies between the base of the mandible and the third cervical verteb ...

posteriorly * the anterior bellies of the

digastric muscle The digastric muscle (also digastricus) (named ''digastric'' as it has two 'bellies') is a small muscle located under the jaw. The term "digastric muscle" refers to this specific muscle. However, other muscles that have two separate muscle belli ...

lateral Lateral is a geometric term of location which may refer to: Healthcare *Lateral (anatomy), an anatomical direction * Lateral cricoarytenoid muscle * Lateral release (surgery), a surgical procedure on the side of a kneecap Phonetics *Lateral co ...

ly.

Communications

The communications of the submental space are: * the

submandibular space The submandibular space is a fascial space of the head and neck (sometimes also termed fascial spaces or tissue spaces). It is a potential space, and is paired on either side, located on the superficial surface of the mylohyoid muscle between the ...

s posterolaterally. * the sublingual space superiorly (via erosion through the mylohyoid).

Its contents are submental

lymph node A lymph node, or lymph gland, is a kidney-shaped organ of the lymphatic system and the adaptive immune system. A large number of lymph nodes are linked throughout the body by the lymphatic vessels. They are major sites of lymphocytes that inc ...

areolar connective tissue Loose connective tissue, sometimes called areolar tissue, is a cellular connective tissue with thin and relatively sparse collagen fibers. Its ground substance occupies more volume than the fibers do. It has a viscous to gel-like consistenc ...

and the

anterior jugular vein The anterior jugular vein is a vein in the neck. Structure The anterior jugular vein lies lateral to the cricothyroid ligament. It begins near the hyoid bone by the confluence of several superficial veins from the submandibular region. Its tri ...

Clinical relevance

This space may be created by pathology, such as the spread of

pus Pus is an exudate, typically white-yellow, yellow, or yellow-brown, formed at the site of inflammation during bacterial or fungal infection. An accumulation of pus in an enclosed tissue space is known as an abscess, whereas a visible collection ...

in an infection.

Odontogenic infection An odontogenic infection is an infection that originates within a tooth or in the closely surrounding tissues. The term is derived from '' odonto-'' (Ancient Greek Ancient Greek includes the forms of the Greek language used in ancient ...

of the mandibular anterior teeth may erode through the lingual cortical plate of the mandible. If the level at which the infection breaks out of the mandible is below the attachment of the mylohyoid, then it will spread into the submental space. However, it is more usual for odontogenic infections to spread into the submental space via first involving the submandibular space. Cutaneous infections or symphyseal/parasymphyseal

mandibular fracture Mandibular fracture, also known as fracture of the jaw, is a break through the mandibular bone. In about 60% of cases the break occurs in two places. It may result in a decreased ability to fully open the mouth. Often the teeth will not feel ...

s may also give rise to a submental space infection. Signs and symptoms of a severe submental abscess include a firm swelling below the chin and

dysphagia Dysphagia is difficulty in swallowing. Although classified under " symptoms and signs" in ICD-10, in some contexts it is classified as a condition in its own right. It may be a sensation that suggests difficulty in the passage of solids or liqu ...

(difficulty swallowing). Treatment is by surgical

incision and drainage Incision and drainage (I&D), also known as clinical lancing, are minor surgical procedures to release pus or pressure built up under the skin, such as from an abscess, boil, or infected paranasal sinus. It is performed by treating the area with ...

, with the incision running transversely in a skin crease behind the chin.

Ludwig's angina Ludwig's angina (lat.: Angina ludovici) is a type of severe cellulitis involving the floor of the mouth and is often caused by bacterial sources. Early in the infection, floor of the mouth raises due to swelling, leading to difficulty swallowing s ...

is a progressive

cellulitis Cellulitis is usually a bacterial infection involving the inner layers of the skin. It specifically affects the dermis and subcutaneous fat. Signs and symptoms include an area of redness which increases in size over a few days. The borders of ...

involving the submandibular, sublingual and submental spaces bilaterally. Ludwig's angina may extend into the pharyngeal and cervical spaces, and the swelling can compress the airway and cause

dyspnoea Shortness of breath (SOB), also medically known as dyspnea (in AmE) or dyspnoea (in BrE), is an uncomfortable feeling of not being able to breathe well enough. The American Thoracic Society defines it as "a subjective experience of breathing dis ...

(difficulty breathing).

References

{{Digestive tract Fascial spaces of the head and neck Mouth Otorhinolaryngology Oral and maxillofacial surgery

Location and structure

Anatomic boundaries

Communications

Contents

Clinical relevance

References