Submental space infection refers to acute suppurative infection in the submental space, with main clinical manifestations including lymphadenopathy, skin congestion in the submental triangle, and pain.

bubble_chart Etiology

The submental space is located in the suprahyoid region and is a single space within the submental triangle. The space contains a small amount of adipose tissue and lymph nodes, and it is separated from the mylohyoid muscle, geniohyoid muscle, and sublingual space. It connects bilaterally with the submandibular space, making it prone to the mutual spread of infection (Figure 1).

Figure 1 Anatomical location of the submental space

Infections in the submental space often originate from lymphadenitis. The lymphatic drainage from the lower lip, tongue tip, floor of the mouth, sublingual caruncle, mandibular anterior teeth, and periodontal tissues directly converges at the submental lymph nodes. Therefore, various inflammations in these areas, such as oral mucosal ulcers and stomatitis, can lead to submental lymphadenitis, which may subsequently develop into cellulitis of the submental space.

bubble_chart Clinical Manifestations

Since submental space infections are mostly caused by the spread of lymph nodes, the disease progression is generally slow. In the early stages, it is limited to lymph node enlargement with no obvious clinical symptoms. Only when the lymph node inflammation spreads beyond the nodes does it lead to cellulitis in the space, at which point the swelling extends to the entire submental triangle, accompanied by skin congestion and pain. After abscess formation, the local skin becomes purplish-red, with pitting edema and fluctuance upon palpation. If the infection spreads posteriorly to the submandibular space, corresponding symptoms may appear.

After abscess formation, a transverse skin incision can be made at the most prominent area of submental swelling, separating the platysma muscle to reach the submental space and establish drainage.