Orbital involvement during the progression of cervicofacial necrotizing fasciitis originating from an odontogenic infection: A case report

Baek, Jae-Ho; Yoon, Jung-Hyun; Jung, Hyun-Soo; Lee, Eui-Seok; Lim, Ho-Kyung

doi:2025.63.11.340

J Korean Dent Assoc > Volume 63(11); 2025 > Article

Case Report

Journal of Korean Dental Association 2025;63(11):340-345.
DOI: https://doi.org/10.22974/jkda.2025.63.11.001 Published online November 30, 2025.

치성 감염으로부터 유발된 두경부 괴사성 근막염의 진행 중 안와 침범을 동반한 증례 보고

Orbital involvement during the progression of cervicofacial necrotizing fasciitis originating from an odontogenic infection: A case report

Jae-Ho Baek¹

¹Department of Oral and Maxillofacial Surgery, Korea University Guro Hospital, Seoul, Korea
²Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, Seoul, Korea

Correspondence: Ho-Kyung Lim, Tel: +82-2-2626-1523,
Email: ungassi@naver.com

Received: 30 August 2025 • Revised: 30 October 2025 • Accepted: 13 November 2025

Abstract

Necrotizing fasciitis of the head and neck is a rare but potentially fatal infection that often arises from odontogenic sources and can rapidly spread along fascial planes to adjacent vital structures. We report a case of a 62-year-old male with diabetes who developed odontogenic necrotizing fasciitis originating from the left mandibular premolar region, which progressed to involve the ophthalmic area. Despite initial incision and drainage with intravenous antibiotics, the infection rapidly advanced with fistula formation and extensive necrosis. The patient underwent repeated debridement, vacuum-assisted closure therapy, and subsequently wide surgical excision followed by reconstructive procedures including a split-thickness skin graft and a pectoralis major flap. With timely multidisciplinary management and strict glycemic control, the patient achieved favorable recovery without recurrence.

Key Words: Necrotizing Fasciitis; Fasciitis; Diabetes Mellitus; Odontogenic; Infection