Danger triangle of the face

The danger triangle of the face.

The dangerous triangle of the face or maxillofacial death pyramid (MDP) consists of the area from the corners of the mouth to the bridge of the nose, including the nose and maxilla.^[1] Due to the special nature of the blood supply to the human nose and surrounding area, it is possible (although very rare) for retrograde infections from the nasal area to spread to the brain.

This is possible because of venous communication (via the ophthalmic veins) between the facial vein and the cavernous sinus. The cavernous sinus lies within the cranial cavity, between layers of the meninges and is a major conduit of venous drainage from the brain.

It is a common misconception that the veins of the head do not contain one-way valves like other veins of the circulatory system. In fact, it is not the absence of venous valves but the existence of communications between the facial vein and cavernous sinus and the direction of blood flow that is important in the spread of infection from the face. Most, but not all, people have valves in the veins of the face.^[2]

An example of disease that may be caused by this process is meningitis, an inflammation of the meninges, the coverings of the brain. Such bacterial infections can be caused by pus entering the brain's blood supply if pimples in the danger triangle are picked.^[3]

Punches or other trauma to the danger triangle of the face can result in brain lacerations, dementia and death.^[4][5]

References

1. ^ Anatomy in Cutaneous Surgery
2. ^ PMID 20491800
3. ^ http://www.doctorspiller.com/cavernoussinus.htm
4. ^ Massimiliano, B, et al. Br J Sports Med. 2011 Jun;45(7):563-70. Epub 2009 Aug 19.
5. ^ Nikolic, SD, Leg Med (Tokyo). 2009 Apr;11 Suppl 1:S321-3. Epub 2009 Mar 4.

External links

• "Cavernous sinus thrombosis: Introduction". National Health Service. 2006-02-10. http://www.nhs.uk/conditions/Cavernous-sinus-thrombosis/Pages/Introduction.aspx?url=Pages/what-is-it.aspx. 
• "Nasal Abscess in Danger Area of Face". http://www.drpaulose.com/ear/ent-pediatric-children/nasal-abscess-in-danger-area-of-face. Retrieved 2011-04-08.