An unusual complication during arthrocentesis: N. facialis paralysis, with N. lingualis and N. alveolaris inferior anesthesia

  • Aliyev, Toghrul (Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Izmir Katip Celebi University) ;
  • Berdeli, Eynar (Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Izmir Katip Celebi University) ;
  • Sahin, Onur (Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Izmir Katip Celebi University)
  • Received : 2019.01.22
  • Accepted : 2019.03.19
  • Published : 2019.04.30


This case report aims to review complications that can occur during arthrocentesis and report an unusual complication observed in a 55-year-old man. The patient received arthrocentesis in an attempt to treat painful locking episodes of his right temporomandibular joint (TMJ). One hour after the operation, the patient experienced temporary facial paralysis in the area of the facial nerve and anesthesia of the lingual and alveolar inferior nerves. No persistent complications were detected during the postoperative follow-up. We suspected this complication occurred after anesthetic solution overflowed from a traumatic perforation in the joint capsule to the infratemporal area during the operation. To our knowledge, this complication has not been previously reported in the literature.



  1. Ohrbach R, Fillingim RB, Mulkey F, Gonzalez Y, Gordon S, Gremillion H, et al. Clinical findings and pain symptoms as potential risk factors for chronic TMD: descriptive data and empirically identified domains from the OPPERA casecontrol study. J Pain 2011; 12: T27-T45.
  2. Tvrdy P, Heinz P, Pink R. Arthrocentesis of the temporomandibular joint: a review. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2015; 159: 31-4.
  3. Al-Moraissi EA. Arthroscopy versus arthrocentesis in the management of internal derangement of the temporomandibular joint: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 2015; 44: 104-12.
  4. Vaira LA, Soma D, Meloni SM, Dellaversana Orabona G, Piombino P, De Riu G. Vertiginous crisis following temporomandibular joint arthrocentesis: a case report. Oral Maxillofac Surg 2017; 21: 79-81.
  5. Keskinruzgar A, Cankal DA, Koparal M, Simsek A, Karadag AS. Investigation of the effects of temporomandibular joint arthrocentesis on blood volume of the retinal structures. J Dent Anesth Pain Med 2019; 19: 37-44.
  6. Carroll TA, Smith K, Jakubowski J. Extradural haematoma following temporomandibular joint arthrocentesis and lavage. Br J Neurosurg 2000; 14: 152-4.
  7. Vaira LA, Raho MT, Soma D, Salzano G, Dellaversana Orabona G, Piombino P, et al. Complications and postoperative sequelae of temporomandibular joint arthrocentesis. Cranio 2018; 36: 264-7.
  8. McCain JP, Sanders B, Koslin MG, Quinn JH, Peters PB, Indresano AT. Temporomandibular joint arthroscopy: a 6-year multicenter retrospective study of 4,831 joints. J Oral Maxillofac Surg 1992; 50: 926-30.
  9. Nitzan DW, Dolwick MF, Martinez GA. Temporomandibular joint arthrocentesis: a simplified treatment for severe, limited mouth opening. J Oral Maxillofac Surg 1991; 49: 1168-70.
  10. Gonzalez-Garcia R, Rodriguez-Campo FJ, Escorial-Hernandez V, Muoz-Guerra MF, Sastre-Perez J, Naval Gias L, et al. Complications of temporomandibular joint arthroscopy: a retrospective analytic study of 670 arthroscopic procedures. J Oral Maxillofac Surg 2006; 64: 1587-91.
  11. Nitzan DW, Dolwick MF. An alternative explanation for the genesis of closed lock symptoms in the internal derangement process. J Oral Maxillofac Surg 1991; 49: 810-5.
  12. Yavuz GY, Keskinruzgar A. Evaluation of complications of arthrocentesis in the management of the temporomandibular joint disorders. Galore Int J Health Sci Res 2018; 3: 50-3.