PSA Block Haematoma — NDEB AFK MCQ

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ModeratePain & Anxiety ControlPSA Block HaematomaNDEB AFK

The pterygoid venous plexus is clinically significant during dental anaesthesia because puncture during a posterior superior alveolar (PSA) nerve block can cause which complication?

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Correct answer: A — Haematoma in the infratemporal fossa

The pterygoid venous plexus lies posterior and superior to the maxillary tuberosity in the infratemporal fossa. During a PSA nerve block, the needle may penetrate this plexus if inserted too far posteriorly or superiorly, causing rapid development of a haematoma in the infratemporal fossa. This presents as progressive extraoral swelling in the temporal and infraorbital regions. Management is direct pressure, ice application, and monitoring. Aspiration before injection reduces but does not eliminate the risk.

Reference: Malamed – Handbook of Local Anesthesia, 7th ed., 2020