Where is a hematoma most likely to form?

Where is a hematoma most likely to form?

• A. PSA (IA's have the 2nd highest rate of hematoma formation)
• B. Infraorbital block
• C. Mental block
• D. Buccal infiltration

Answer: (A)

Hematoma risk is highest when the injection path goes through or very near a region with dense vascular networks and large vessels. The posterior superior alveolar (PSA) block passes close to the pterygopalatine region and the posterior superior alveolar artery, with the pterygoid venous plexus nearby. If a vessel is nicked during needle advancement or withdrawal, blood can spread into the infratemporal space and cheek, producing a hematoma. That anatomical setup makes this injection the most likely source of a hematoma compared with the other techniques. In contrast, buccal infiltration is a superficial technique that stays within the buccal mucosa and alveolar bone vicinity with smaller vessels, so bleeding hematomas are much less common. A mental block is near the mental foramen where the vessels are smaller and more nerve-focused blocks tend to bleed less intradurally. An infraorbital block travels along the infraorbital canal but generally involves fewer large vessels in the immediate path than the PSA region, so the risk is lower than for the PSA block.

Hematoma risk is highest when the injection path goes through or very near a region with dense vascular networks and large vessels. The posterior superior alveolar (PSA) block passes close to the pterygopalatine region and the posterior superior alveolar artery, with the pterygoid venous plexus nearby. If a vessel is nicked during needle advancement or withdrawal, blood can spread into the infratemporal space and cheek, producing a hematoma. That anatomical setup makes this injection the most likely source of a hematoma compared with the other techniques.

In contrast, buccal infiltration is a superficial technique that stays within the buccal mucosa and alveolar bone vicinity with smaller vessels, so bleeding hematomas are much less common. A mental block is near the mental foramen where the vessels are smaller and more nerve-focused blocks tend to bleed less intradurally. An infraorbital block travels along the infraorbital canal but generally involves fewer large vessels in the immediate path than the PSA region, so the risk is lower than for the PSA block.