A patient presents to the emergency department with floor of mouth swelling following tori removal. What is the most likely etiology?

A patient presents to the emergency department with floor of mouth swelling following tori removal. What is the most likely etiology?

• A. Seroma from the surgical site
• B. Hematoma from sublingual branch of lingual artery
• C. Infection from surgical intervention
• D. Allergic reaction to anesthetics

Answer: (B)

The presence of floor of mouth swelling following tori removal is most commonly attributed to a hematoma, particularly involving the sublingual branch of the lingual artery. During the surgical procedure, the lingual artery can be inadvertently nicked or damaged, leading to bleeding in the confined space of the floor of the mouth. As blood accumulates in this area, it creates pressure and swelling, characterized as a hematoma. Hematomas in the floor of the mouth can present dramatically due to the anatomical constraints and the proximity of vital structures, such as the airway. Immediate recognition of this complication is critical, as a significant hematoma can lead to airway compromise. The thorough understanding of vascular anatomy in this region aids in anticipating and managing such complications effectively. While other factors, such as seromas and infections, can cause swelling postoperatively, the acute nature and timing of the swelling with the surgical intervention point more directly to hematoma formation as the most likely etiology in this context. Similarly, allergic reactions to anesthetics, while possible, generally present differently and would not be as localized specifically to the floor of the mouth following a procedure focused there.

The presence of floor of mouth swelling following tori removal is most commonly attributed to a hematoma, particularly involving the sublingual branch of the lingual artery. During the surgical procedure, the lingual artery can be inadvertently nicked or damaged, leading to bleeding in the confined space of the floor of the mouth. As blood accumulates in this area, it creates pressure and swelling, characterized as a hematoma.

Hematomas in the floor of the mouth can present dramatically due to the anatomical constraints and the proximity of vital structures, such as the airway. Immediate recognition of this complication is critical, as a significant hematoma can lead to airway compromise. The thorough understanding of vascular anatomy in this region aids in anticipating and managing such complications effectively.

While other factors, such as seromas and infections, can cause swelling postoperatively, the acute nature and timing of the swelling with the surgical intervention point more directly to hematoma formation as the most likely etiology in this context. Similarly, allergic reactions to anesthetics, while possible, generally present differently and would not be as localized specifically to the floor of the mouth following a procedure focused there.