1. Ocular complications after posterior superior alveolar nerve block: a case of trochlear nerve palsy
- Author
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C. Chisci, Elettra Chisci, Glauco Chisci, and V. Chisci
- Subjects
Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Anesthesia, Dental ,Carticaine ,Articaine ,Superior oblique muscle ,medicine ,Diplopia ,Maxillary Nerve ,Humans ,medicine.cranial_nerve ,Palsy ,business.industry ,Trochlear nerve ,Posterior superior alveolar nerve ,Nerve Block ,Surgery ,Trochlear Nerve Diseases ,Otorhinolaryngology ,Oculomotor Muscles ,Anesthesia ,Nerve block ,Molar, Third ,Oral Surgery ,medicine.symptom ,business ,Complication ,medicine.drug ,Anesthesia, Local - Abstract
Many intraoperative complications occurring during third molar surgery are described in the literature. Unilateral trochlear nerve palsy secondary to dental anaesthesia is a rare complication. We report the case of a 36-year-old healthy man, ASA I classification, requiring upper third molar extraction. Articaine 1:200,000 epinephrine for right posterior superior alveolar (PSA) nerve block was administered locally in the mucobuccal fold above the upper third molar. A few minutes after PSA nerve block the patient experienced double-vision. The patient was subsequently visited by an ophthalmologist and the condition was diagnosed as transient unilateral vertical diplopia due to temporary paralysis of the superior oblique muscle as a result of the anaesthetic solution involving the IV cranial nerve. The authors report this unusual case and discuss the possible anatomical pathways that might explain this rare phenomenon.
- Published
- 2012