Abstract
Background
Upper third molar exodontia is one of the most common and simple dentoalveolar surgical procedures. Complications, such as bleeding from the posterior superior alveolar vessels are rare but potentially dangerous.
Methods
This article describes a case of postoperative hematoma of the temporal and infratemporal fossa after simple upper third molar extraction.
Results
The etiology of this uncommon complication could be rupture of the posterior superior alveolar vessels during injection of the local anesthetic. The absence of concomitant tearing of the periosteal envelope overlying the maxillary tuberosity may force blood backwards and upwards along the external pterygoid muscle into the infratemporal fossa and further along the anterior border of the temporal muscle. In two previously reported cases, the hemorrhage spread up into the infratemporal fossa and through the inferior orbital fissure into the orbit. In the case described here the bleeding stopped spontaneously; nevertheless, inpatient observation was indicated because of the possibility that a retrobulbar hematoma might develop.
Conclusion
Uncomplicated upper third molar extraction is one of the most common procedures of oral and maxillofacial surgery but can nevertheless trigger unexpected late complications, such as bleeding into the deep skull spaces. In such cases referral to an oral maxillofacial surgeon is essential for appropriate follow-up and management.
Similar content being viewed by others
References
Dunne CM, Goodall CA, Leicht JA, Russell DI. Removal of third molars in Scottish oral and maxillofacial units: a review of practices in 1995 and 2002. Br J Oral Maxillofac Surg. 2006;44:313–6.
Chuang SK, Perrott DH, Susarla MS, Dodson TB. Age risk factor for third molar surgery complications. J Oral Maxillofac Surg. 2007;65:1685–92.
Sagara Y, Kiyosue H, Tanoue S, Shimada R, Hongo N, Kohno T, Kawano K, Mori H. Selective transarterial embolization with n-butyl-2-cyanoacrylate for the treatment of arterial hemorrhage after third molar extraction. Neuroradiology. 2013;55:725–31.
Wartburton G, Brahim JS. Intraorbital hematoma after removal of upper third molar: a case report. J Oral Maxillofac Surg. 2006;64:700–4.
Goshatasby P, Miremadi R, Warwar R. Retrobulbar hematoma after third molar extraction: case report and review. J Oral Maxillofac Surg. 2010;68:461–4.
Benazzou S, Cheynet F, Brignol L, Guyot L, Chossegros C. Third molar extraction with massive hemorrhage treated by embolization. J Craniofac Surg. 2009;20:575–6.
Bertram AR, Rao AC, Akbiyik KM, Haddad S, Zoud K. Maxillary tuberosity fracture: a life-threatening haemorrhage following simple exodontia. Aust Dent J. 2011;56:212–5.
Conflict of interest
Mauro Pau, Ákos Bicsák, Knut Ernst Reinbacher and Hans Kärcher declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Pau, M., Bicsák, Á., Reinbacher, K. et al. Temporal and infratemporal hematoma. J. Stomat. Occ. Med. 7, 77–80 (2014). https://doi.org/10.1007/s12548-014-0107-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12548-014-0107-1