Masticatory (submasseterial) phlegmon

They are relatively rare, and may be confused with a parotitis. They
tend to be chronic. The submasseteric space is infected from
infections that spread from the buccal space.
Borders
Frontal: front edge of masseter
Back: back edge of the jaw branch
Outside: inner surface of masseter muscle
Inside: outer surface of the lower jaw branch
Above: lower edge of zygomatic arch
Below: lower edge of the body of the lower jaw
Etiology & Clinical Manifestations
-The common organisms associated may be either aerobic like α
hemolytic streptococci, Staphylococcus, Streptococcus pneumoniae,
Enterobacteriacae, Proteus, Klebsiella and Mycobacterium
tuberculosis, or anaerobic like Bacteroides,
Prevotella and Fusobacterium.
Recognized symptoms include swelling and pain secondary to
abscess collection in the confined space, trismus due to involvement
of the masseter muscle, malaise and fever.
Diagnoses
The differential diagnosis of swelling in this region includes parotid
gland pathology, masseteric hypertrophy, and tempo mandibular
joint disorders.
Treatment
The key to resolving the infection is via surgical intervention to
evacuate the pus. Although it is possible and occasionally practical
to drain the submasseteric space via an intraoral approach, an
extra oral approach may sometimes be required. The treatment of a
submasseteric space infection is usually by surgical incision and
drainage, and the incision is placed intra-orally (inside the mouth)
or both intra and extra-orally if other parts of the masticator space
are involved.