30/05/2026
🦷 Why does a Pterygoid Plexus Injury occur during a Posterior Superior Alveolar (PSA) Nerve Block?
One of the most common complications of a PSA nerve block is injury to the pterygoid venous plexus, resulting in immediate swelling, bruising, and hematoma formation.
🔍 Common Causes:
✅ Excessive needle depth beyond the recommended limit
✅ Incorrect angulation of the needle during insertion
✅ Failure to maintain proper anatomical landmarks
✅ Multiple needle penetrations and redirections
🛡️ How can it be prevented?
✔️ Thorough understanding of maxillary anatomy
✔️ Adhering to recommended needle depth and angulation
✔️ Gentle and controlled needle advancement
✔️ Always aspirate before depositing local anesthetic
✔️ Avoid unnecessary needle repositioning
Clinical mastery comes from understanding not only how to perform a nerve block, but also how to prevent and manage its complications.
👇 Have you ever encountered a hematoma or pterygoid plexus injury during a PSA block? Share your experience or ask your clinical questions in the comments below. Let’s learn from each other’s experiences!
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