Hospital Universitario de Canarias, Servicio de Cirugía Oral y Maxilofacial, La Laguna,Tenerife, Spain,
Med Oral Patol Oral Cir Bucal. 2010 May 1;15(3):e509-11. doi: 10.4317/medoral.15.e509.
Removal of an impacted superior third molar is usually a simple and uncomplicated procedure for an Oral and Maxillofacial Surgeon. Nevertheless, complications are possible and include infection, facial swallowing, trismus, wound dehiscence, root fracture or even orosinusal fistula. Iatrogenic displacement into the infratemporal fossa is frequently mentioned but rarely reported. This anatomical fossa includes several important structures such as the internal maxillary artery, the venous pterygoid plexus, the sphenopalatine nerve, the coronoid process of the mandible and the pterygoid muscles. Recommended treatment includes immediate surgical removal if possible or initial observation and secondary removal, as necessary, because of infection, limited mandibular movement, inability to extract the tooth, or the patient's psychological unease. Sometimes, the displaced tooth may spontaneously migrate inferiorly and becomes accessible intraorally. This report describes the location and secondary surgical removal of a left maxillary third molar displaced into the infratemporal fossa, two weeks after first attempt at extraction.
拔除阻生的上颌第三磨牙通常是口腔颌面外科医生的一项简单而不复杂的手术。然而，也可能出现并发症，包括感染、面颊肿胀、牙关紧闭、伤口裂开、牙根骨折，甚至口鼻瘘。医源性移位至颞下窝虽常被提及，但鲜有报道。该解剖学窝包含几个重要结构，如上颌内动脉、翼丛静脉、蝶腭神经、下颌喙突和翼内肌。如果可能，建议立即手术取出；如果出现感染、下颌运动受限、无法拔牙、患者心理不适等情况，则需要进行初始观察和二次取出。有时，移位的牙齿可能会自行向下迁移，变得可在口腔内触及。本报告描述了一例左上第三磨牙在初次拔牙后两周，移位至颞下窝，然后对其进行定位和二次手术取出的过程。
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