Читать книгу Clinical Anatomy for Oral Implantology - Louie Al-Faraje - Страница 16

The pterygoid venous plexus is situated on the medial side of the mandibular ramus within the pterygoid muscles. It is linked to the facial vein via the deep facial vein, to the retromandibular vein via the maxillary vein, and to the cavernous sinus via the sphenoidal emissary vein. The pterygoid plexus drains into the jugular veins.

This plexus is of a special importance to dentists because if the needle is overinserted during posterosuperior alveolar block, it may penetrate the pterygoid plexus of the vein and the maxillary artery in the infratemporal fossa (Fig 1-9), thus causing hematoma. This results in extraoral swelling a few minutes after the injection. The hematoma will cause tissue tenderness and discoloration, which will last until the blood is broken down by the body, and possible spread of infection to the cavernous venous sinus if the needle is contaminated. A hematoma can also result during other blocks, such as infraorbital and inferior alveolar blocks. To avoid injection into blood vessels, aspiration should always be attempted for all injections.

FIG 1-9 Pterygoid venous plexus.