The hematoma is most likely to form in which vascular area during PSA injection?

The hematoma is most likely to form in which vascular area during PSA injection?

• A. Pterygoid plexus
• B. Infraorbital artery
• C. Lingual artery
• D. Facial vein

Answer: (A)

During a PSA injection, the needle path sits very close to a large venous network in the infratemporal fossa that surrounds the maxillary tuberosity—the pterygoid venous plexus. This plexus drains the area of the maxilla and courses near where the PSA nerve travels. If a vessel in that plexus is punctured, bleeding pours into the infratemporal space and can manifest as a hematoma that often tracks into the cheek region. The other vessels listed are less likely to be the source of the typical PSA-related hematoma: the infraorbital artery is an arterial structure that runs with the infraorbital nerve higher in the orbit, the lingual artery lies in the floor of the mouth, and the facial vein is more superficial and less directly involved in the deep infratemporal hematoma that PSA injections can produce.

During a PSA injection, the needle path sits very close to a large venous network in the infratemporal fossa that surrounds the maxillary tuberosity—the pterygoid venous plexus. This plexus drains the area of the maxilla and courses near where the PSA nerve travels. If a vessel in that plexus is punctured, bleeding pours into the infratemporal space and can manifest as a hematoma that often tracks into the cheek region. The other vessels listed are less likely to be the source of the typical PSA-related hematoma: the infraorbital artery is an arterial structure that runs with the infraorbital nerve higher in the orbit, the lingual artery lies in the floor of the mouth, and the facial vein is more superficial and less directly involved in the deep infratemporal hematoma that PSA injections can produce.