Abstract

Necrotizing fasciitis of the head and neck is a rare but potentially fatal infection that often arises from odon-togenic 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 man-dibular 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 exci-sion 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.