PMC8407642_01
Sublingual hematoma leading to an elevated and retruded tongue position, which, in addition, is enlarged and indurated
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F1
Intraoral exploration revealed a prominent, but apparently stable 5 x 4 cm hematoma in the floor of the mouth, pushing the tongue against the pharynx and palate, causing subtotal oropharyngeal obstruction [Figure 1].
(a) Coronal computed tomography scan view showing diffuse enlargement of the floor of the mouth and tongue with subsequent airway space collapse. No drainable hematic collections can be appreciated. (b) 3D reconstruction image showing the performed implant procedure in the mandible. Maxillary implants had been placed in a previous surgical session. Deliberate implant inclination at the canine areas (marks) for occlusal purposes is the usual underlying cause of lingual cortex perforation. (c) Axial and lateral computed tomography scan views showing lingual mandibular cortex perforations at the canine areas (arrows)
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F2
The patient was able to complete his implant-based rehabilitation (a). Minimal scarring in the neck (b) due to tracheostomy was the only sequel after 1 year
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F3
No implant removal was necessary [Figure 3].