Case

A 40 year old patient is admitted into your care after having taken several blows to the head and face during a fist fight. Their chin is slightly offset to the left and there is a hard protuberance in front of their right ear. The patient is unable to close their mouth and is experiencing excruciating pain.  

Question 22 - What structures are in the vicinity that are at risk of being injured?

Click on your selected option(s) below  (correct = 3, over-thinking = 4+)

Case Complete

Incorrect. The internal carotid artery is quite deep and the anterior displacement of the mandible unlikely to damage the vessel.  

Correct! The facial nerve is in close proximity to the mandible and anterior displacement would pull the facial (VII) nerve. Usually, only minor inflammatory responses from a dislocation.

Correct! The pterygoid venous plexus is extensive deep and posterior to the mandible and could be disrupted with a violent dislocation. This may result in a hematoma or bruising within the area.

Incorrect. While movement of the jaw 'pulls' on the facial artery, the artery normally is pulled around during chewing and opening of the jaw. So the vessel is designed to accommodate movement without stretch injury. 

Correct. The inferior alveolar nerve (branch from CN V3 mandibular nerve) courses into the mandibular foramen. Dislocation of the mandible would put a stretch strain onto this nerve.  Usually, only minor inflammatory responses from a dislocation.

Incorrect. The infraorbital nerve emerges from the infraorbital foramen which is not part of the mandible. Thus, mandible dislocation would not directly damage or inflame this nerve.