Deep spaces of the neck

Deep spaces of neck

Accurate interpretation of head and neck imaging requires an understanding of fascial layers, which cannot be precisely delineated with imaging; in practice, key anatomic landmarks define these fascial layers.

Cross sectional imaging is the mainstay of evaluation. In certain scenarios ultrasound can also be used to assess the lesion. Neither CT or MRI is universally superior, both provide complementary diagnostic value. However, MRI is generally considered superior for the definitive characterization and local staging of soft-tissue lesions.

CT remains the first line modality due to faster acquisition, ability to perform maneuvers like puffed cheek scan for oral cavity lesions, and its high sensitivity for evaluating bone erosions.

Spaces of the neck are enclosed by:

• Superficial cervical fascia: subcutaneous fat + platysma

• Deep cervical fascia: further divided into:

  1. Superficial DCF

  2. Middle DCF

  3. Deep DCF

Deep spaces of the neck are the compartments lined by the layers of the deep cervical fascia.

These are majorly divided into:

I. Suprahyoid Neck

• Parotid Space

• Masticator Space (Subdivided into Infrazygomatic and Suprazygomatic)

• Submandibular Space

• Parapharyngeal Space'

II. Infrahyoid Neck

• Anterior Cervical Space

• Suprasternal Space

• Strap Muscle Compartment

  
  

III. Suprahyoid + Infrahyoid Neck

• Carotid Space

• Visceral Space

• Retropharyngeal Space

• Perivertebral Space

• Posterior Cervical Space