[Infracondylar abscess formation: a rare complication of local anesthesia].
BACKGROUND
Ninety percent of oro-facial infections arise from a dental origin. The remaining 10% are the consequence of oro-pharyngeal, cutaneous or iatrogenic problems, such as in the present case.


METHODS
A 24-year-old patient consulted the emergency room because of a left mandibular swelling, accompagnied by trismus. Four days earlier, extraction of the 38 was performed under inferior alveolar nerve block anesthesia. A first drainage by vestibular approach was performed under general anesthesia. Because of the absence of improvement, a CT-scan was performed and an abscess localized at the base of the condyle, surrounding the posterior margin of the mandible, very high above the lingula. Outcome was favourable after a second surgery.


CONCLUSIONS
Formation of an abscess very high above the lingula, around the condylar neck is rarely reported in the literature. In this patient it was certainly a complication resulting from the injection of local anesthesic with a vasoconstrictor. CT-scan should be performed to guide diagnosis in the event of an unusual course after the first surgical procedure and an adequate antibiotic regimen.
Dojcinovic
I
I
Département de Chirurgie, Service de Chirurgie Maxillo-faciale et de Chirurgie Buccale, Hôpital Cantonal de Genève, Suisse. ivan.dojcinovic@hcuge.ch
Hugentobler
M
M
Richter
M
M
D000038:Abscess / Q000209:etiology*; D000328:Adult; D000766:Anesthesia, Dental / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000008:administration & dosage; D006801:Humans; D007267:Injections / Q000009:adverse effects; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008335:Mandibular Condyle / Q000473:pathology*; D008336:Mandibular Diseases / Q000209:etiology*; D008340:Mandibular Nerve; D009407:Nerve Block / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D014313:Trismus / Q000209:etiology
D000779:Anesthetics, Local; D008012:Lidocaine