Aneurysm of the distal facial artery from a penetrating oral prosthesis.

We report a 94-year-old male who died of pneumonia. During the routine dissection of the head and neck for a gross anatomy course at our institution a mass was noted in the region of the right cheek. Macroscopic and microscopic observation of this mass revealed an aneurysm of the facial artery. A traumatic defect was noted at the apex of the aneurysmal wall related to an intraoral prosthetic clasp that had penetrated the buccinator muscle. Traumatic aneurysms of the face have been caused by blunt trauma to the jaw with or without fracture, surgical manipulation around the teeth and jaw, and following missile injury. Some have described compression of neighboring structures such as cranial nerves and other blood vessels with resultant compromise. We believe our case to be the first report of a facial artery aneurysm in a cadaver and we are unaware of other reports from the literature describing the production of a facial artery aneurysm from a puncture of an intraoral prosthesis through the medially placed buccinator muscle. Although seemingly rare, health care professionals should make efforts to ensure that oral prostheses do not develop sharp or irregular edges that could potentially perforate the lateral oral cavity with potential perforation of the overlying vasculature.