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 anterior and posterior bellies of the digastric muscle. The space corresponds to the anatomic region termed the

submandibular triangle The submandibular triangle (or submaxillary or digastric triangle) corresponds to the region of the neck immediately beneath the body of the mandible. Boundaries and coverings It is bounded: * ''above'', by the lower border of the body of the man ...

, 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 Mu ...

Location and structure

Anatomic boundaries

The anatomic boundaries of each submandibular space are: * the mylohyoid muscle superiorly, * the skin, superficial fascia, platysma muscle and superficial layer of the

deep cervical fascia The deep cervical fascia (or fascia colli in older texts) lies under cover of the platysma, and invests the muscles of the neck; it also forms sheaths for the carotid vessels, and for the structures situated in front of the vertebral column. Its a ...

inferiorly and laterally, * the medial surface of the mandible anteriorly and laterally, * 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 vertebr ...

posteriorly, * the anterior belly of the digastric muscle medially.

Communications

The communications of the submandibular space are: * medially and anteriorly to the

submental space The submental space is a fascial space of the head and neck (sometimes also termed fascial spaces or tissue spaces). It is a potential space located between the mylohyoid muscle superiorly, the platysma muscle inferiorly, under the chin in the m ...

(located medial to the paired submandibular spaces, separated from them by the anterior bellies of the digastric muscles). * posteriorly and superiorly to the

sublingual space The sublingual space is a fascial space of the head and neck (sometimes also termed fascial spaces or tissue spaces). It is a potential space located below the mouth and above the mylohyoid muscle, and is part of the suprahyoid group of fascial sp ...

(located above the mylohyoid muscle) * inferiorly to the

lateral pharyngeal space The parapharyngeal space (also termed the lateral pharyngeal space), is a potential space in the head and the neck. It has clinical importance in otolaryngology due to parapharyngeal space tumours and parapharyngeal abscess developing in this area. ...

Contains

In health, the contents of the space are: * the

submandibular gland The paired submandibular glands (historically known as submaxillary glands) are major salivary glands located beneath the floor of the mouth. They each weigh about 15 grams and contribute some 60–67% of unstimulated saliva secretion; on stimula ...

, which largely fills the space, * branches of the

facial and lingual artery A facial is a family of skin care treatments for the face, including steam, exfoliation (physical and chemical), extraction, creams, lotions, facial masks, peels, and massage. They are normally performed in beauty salons, but are also a com ...

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 inclu ...

s. * cranial nerve XII * nerve to mylohyoid muscle

Clinical relevance

Infections may spread into the submandibular space, e.g. odontogenic infections, often related to the

mandibular molar The molars or molar teeth are large, flat teeth at the back of the mouth. They are more developed in mammals. They are used primarily to grind food during chewing. The name ''molar'' derives from Latin, ''molaris dens'', meaning "millstone to ...

teeth. This is due to the fact that the attachment of mylohyoid (the mylohyoid line) becomes more superior towards the posterior of the mandible, meaning that the roots of the posterior teeth are more likely to be below mylohyoid than above. Signs and symptoms of a submandibular space infection might include trismus (difficulty opening the mouth), inability to palpate (feel) the inferior border of the mandible and swelling of the face over the submandibular region. If the space contains pus, the usual treatment is by incision and drainage. The site of the incision is extra-oral, and usually made 2–3 cm below, and parallel to, the inferior border of the mandible. Ludwig's angina is a serious infection 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 (difficulty breathing).

References

{{mouth anatomy Fascial spaces of the head and neck Otorhinolaryngology Oral and maxillofacial surgery Mouth