Some (more) journal articles about artery injuries during oral surgey. Not sure if some of them were due to weird or unpredictable vessel anatomy. But for sure, most due to
IATROGENIC INJURIES which means
DOCTOR CAUSED injuries.
"Diagnosis and management of blunt carotid artery injury in oral and maxillofacial surgery."
https://www.ncbi.nlm.nih.gov/pubmed/9393397Distressing to find that's also a risk. In this paper, they track 12 patients in a 2 year period, all of whom had BLUNT injury from the surgery with terrible neurological deficits of those that survived (didn't die from it). They say it's a rare complication. But here, they are talking about BLUNT injury which is different from artery actually being severed which is much worse.
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"Massive Hemorrhage During Oral and Maxillofacial Surgery: Ligation of the External Carotid Artery or Embolization?"
https://www.joms.org/article/S0278-2391(09)00304-8/fulltext----
"Internal carotid artery thrombosis after blunt maxillofacial trauma"
https://www.oooojournal.net/article/0030-4220(91)90548-Q/fulltextThis paper is about the
artery being damaged during a LEFORT 3 and mandible angle fracture. The patients didn't die but it looked to be a 'wait and see' process until the time they noticed neurologic deficit and extreme weakness (hemiparesis) of one side of body.
"Abstract
Two cases of internal carotid artery thrombosis associated with a maxillary Le Fort III and mandibular angle fractures after maxillofacial blunt injuries are described. Both patients had delayed neurologic deficit and hemiparesis. The diagnosis was made by carotid angiography after clinical evidence of thromboembolism. Clinical aspects and etiology, with special attention to mechanism of injury, are discussed."
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"Massive Hemorrhage During Oral and Maxillofacial Surgery: Ligation of the External Carotid Artery or Embolization?"
https://www.researchgate.net/publication/26296626_Massive_Hemorrhage_During_Oral_and_Maxillofacial_Surgery_Ligation_of_the_External_Carotid_Artery_or_EmbolizationThat's just the FIRST TITLE of the LINK given here. On the same link, there are a BOAT LOAD of articles/case studies about massive bleeding and artery damage during maxillo-facial surgery.
Some snippets from the series of articles. Some of which are about massive bleeding even after a tooth extraction!:
"....As far as we could determine, this triangular space has not been described before [22,25,28]. Even today, penetrating injuries to the head and neck region associated with significant arterial Posterior auricular artery, 12 Superficial temporal artery, 13 Internal carotid artery, 14 Common carotid artery, 15 Superior thyroid artery, 16 Lingual artery, 17 Hypoglossal nerve bleeding constitute surgical emergencies that are frequently very difficult to handle [2,3,5,29]. The literature suggests that about 25% of penetrating neck trauma cases are associated with vascular injuries, with the internal carotid being the most frequently affected artery [5,30]...."
"Stab injury to the preauricular region with laceration of the external carotid artery without involvement of the facial nerve: A case report."
"Life-threatening bleeding after tooth extraction due to vascular malformation: a case report and literature review."
"Massive bleeding after a tooth extraction: Diagnosis of unknown arteriovenous malformation of the mandible, a case report"
"A Critical Review of the Literature and an Evidence-Based Approach for Life-Threatening Hemorrhage in Maxillofacial Surgery"
The list goes on with MANY other articles.