An Unusual Presentation of a Neck Mass – Traumatic Pseudoaneurysm Following Third Molar Surgery: A Case Report

Abstract

Traumatic pseudoaneurysm (TPA) is an extremely rare complication following a tooth extraction. TPAs are vascular lesions that occur due to extravasated blood that is still contained by the adventitia or adjacent soft tissue. This sac of blood may continue to expand, leading to superimposed infection, severe hemorrhage, or thromboembolism. In the maxillofacial region, TPA is most often associated with penetrating trauma, condylar fractures, or orthognathic surgery and can present days to weeks following the inciting event. The purpose of this paper is to review the management of a rare facial artery TPA following routine mandibular third molar tooth extraction in a 19-year-old healthy male. A computed tomography angiography and color Doppler ultrasound were used for diagnosis of the TPA. The initial treatment involved endovascular embolization followed by surgical excision due to the delayed appearance of a large 3-cm upper neck mass. While TPA is a rare complication following third molar surgery, we report the first case presenting to the head and neck surgeon as a unilateral neck mass following definitive endovascular therapy.