Maxillary tuberosity fracture and subconjunctival hemorrhage following extraction of maxillary third molar
A 52-year-old man was referred to our department by a private dental practitioner after attempted extraction of left upper third molar with peri-orbital and subconjunctival ecchymosis of left eye and hematoma of left maxillary tuberosity and buccal mucosa. Detailed history revealed that the patient noticed redness in his left eye on the day of the dental procedure. His medical history revealed that he has vitiligo and was undergoing treatment for the same for the past 3 years. Patient denied any bleeding disorders and reported that he had undergone uneventful extraction few months back. There was no significant personal and family history. On examination, patient's vital signs were all within normal limits with no neurological deficit.\nExtra oral examination revealed peri-orbital and subconjunctival ecchymosis with posterior limit and patches of hypopigmentation (vitiligo) around the peri-oral, nasal, and neck region []. His vision and movements of the globe were normal. Intra oral examination revealed a large hematoma in the region of left maxillary tuberosity region and a mobile upper third molar []. CT scan revealed a grossly decayed left upper third molar with fractured posterolateral wall of left maxillary sinus and opacification [Figures and ]. After consultation with ophthalmologist, conservative management with antibiotic eye drops and benzalkonium chloride were prescribed. Patient vision monitored regularly for the visual disturbances or progressive loss of vision.\nLeft upper third molar was surgically removed by loosening the gingival cuff and removing as little bone as possible to retain the tuberosity with the periosteum. Tissues were closed with watertight closure. Patient was followed up for 3 weeks, at the end of which there was a complete resolution of subconjunctival followed by peri-orbital ecchymosis.