Right Zygomaticomaxillary Complex Fracture With Rupture Of Internal Maxillary Artery: A Case Report

2016 ◽  
Vol 3 (1) ◽  
pp. 27-31
Author(s):  
Beni Herlambang ◽  
Budiman Budiman
Keyword(s):  
Carotid Artery ◽  
Massive Bleeding ◽  
External Carotid Artery ◽  
External Carotid ◽  
Maxillary Artery ◽  
Internal Maxillary Artery ◽  
Complex Fracture ◽  
Zygomaticomaxillary Complex Fracture ◽  
Life Threatening ◽  
Zygomaticomaxillary Complex

Background: This case report gives prominence to the risk of delayed, possibly life - threatening bleeding following mid-facial fractures. Methods: A 42-year-old male was involved in an accident during which he suffered from right zygomaticomaxillary complex fractures with massive bleeding. The hemoglobin level was decreased from 11 to 5 g/dL, suspected caused by rupture of internal maxillary artery. Incidence of massive bleeding due to zygomaticomaxillary complex fracture is quite rare. Patient also felt right visual loss due to retrobulbar hematoma compression. He was given nasal tampon and transfusion in referral hospital. The patient had fracture reconstruction (reduction and fixation), ligation of right facial artery and temporary ligation of external carotid artery with Ethiloop for 5 days. Nevertheless, the bleeding still occurred. The patient then underwent Digital Subtraction Angiography (DSA) and coiling procedure from radiologic intervention. Twenty days after last procedure, we ligated the right external carotid artery due to recurrence of bleeding. Results: There are many modalities and procedure for the therapy of massive bleeding on midface fracture, ranging from conservative, minimal invasive to operative surgery. Patient that has gone through DSA procedure can still bleed. After ligation of external carotid artery, no more bleeding occurred. Conclusion: Patient suffering from extensive midfacial fracture, the internal maxillary artery and its branches are at special risk of injury due to their close anatomical relationship to bony structures. Its bleeding is possibly life threatening. Tampon and nasal packing are non-essential initial treatment, but digital pressure procedure can be performed to stop the bleeding temporarily. Ligation of external carotid artery is the best choice of treatment for permanent outcome.

Traumatic Dissection of the Internal Maxillary Artery Associated with Isolated Glossopharyngeal Nerve Palsy: Case Report

Neurosurgery ◽  
2004 ◽  
Vol 55 (3) ◽  
pp. E718-E721
Author(s):  
Jung Yong Ahn ◽  
Young Sun Chung ◽  
Sang Sup Chung ◽  
Pyeong Ho Yoon
Keyword(s):  
Carotid Artery ◽  
Cranial Nerve ◽  
Nerve Palsy ◽  
False Lumen ◽  
External Carotid Artery ◽  
Neurological Deficits ◽  
External Carotid ◽  
Artery Dissection ◽  
Maxillary Artery ◽  
Internal Maxillary Artery

Abstract OBJECTIVE AND IMPORTANCE: Spontaneous or traumatic dissection of the internal carotid artery with resultant lower cranial nerve palsies is well documented. However, dissection of the external carotid artery with lower cranial palsies has not been reported previously. CLINICAL PRESENTATION: A 42-year-old man experienced an epidural hematoma as the result of a fall and underwent a craniotomy and hematoma removal. Subsequently, he developed dysgeusia and difficulty in swallowing. Brain magnetic resonance imaging showed a dilated linear structure, with isosignal intensity on T1-weighted images and hyperintense signal intensity on T2-weighted images. Strong enhancement was seen on postcontrast T1-weighted images, indicating a dissected internal maxillary artery. This was confirmed on selective angiography of the left common carotid artery. INTERVENTION: Guglielmi detachable coils were introduced into the false lumen of the dissected artery. Subsequently, 0.5 ml of glue mixed with Lipiodol (Lafayette Pharmacal, Lafayette, IN) was packed into the remnant of the false lumen. Repeat angiograms demonstrated complete occlusion of the dissected vessel. The patient's postoperative course was uneventful, and the neurological deficits gradually improved. CONCLUSION: We describe the first reported case of internal maxillary artery dissection and pseudoaneurysm presenting with isolated glossopharyngeal nerve palsy. The association between cranial nerve palsy and dissection of the external carotid artery branch may be the result of a compressive mechanism, as suggested by its anatomic relationships, the characteristics of the dissection, and the good prognosis. Endovascular embolization of the external carotid artery dissection and pseudoaneurysm is suggested as an effective therapeutic method for improving or alleviating neurological deficits produced by mass effect.

An aberrant artery as a cause of massive bleeding following adenoidectomy

2002 ◽  
Vol 116 (4) ◽  
pp. 299-300 ◽  
Author(s):  
J. P. Windfuhr
Keyword(s):  
Carotid Artery ◽  
Surgical Procedure ◽  
Rare Complication ◽  
Massive Bleeding ◽  
External Carotid Artery ◽  
External Carotid ◽  
General Anaesthetic ◽  
Ascending Pharyngeal Artery ◽  
Aberrant Artery ◽  
Almost All

Bleeding following adenoidectomy is a rare complication of this surgical procedure, and usually occurs in the first post-operative hours. In almost all cases it is related to adenoid remnants. Removal of these remnants under a second general anaesthetic is the treatment of choice. We report a case of massive bleeding three days following adenoidectomy related to the injury of an aberrant ascending pharyngeal artery during adenoidectomy performed elsewhere. Signs of manifest shock necessitated an immediate ligature of the external carotid artery and its individual branches. The post-operative course was uneventful. Two years later the boy underwent tonsillectomy without complications.

Giant life-threatening external carotid artery pseudoaneurysm caused by a mandibular condylar fracture

2015 ◽  
Vol 119 (3) ◽  
pp. e95-e100 ◽  
Author(s):  
André Luis Ribeiro Ribeiro ◽  
Walessa Brasil da Silva ◽  
Sérgio de Melo Alves-Junior ◽  
João de Jesus Viana Pinheiro
Keyword(s):  
Carotid Artery ◽  
External Carotid Artery ◽  
External Carotid ◽  
Condylar Fracture ◽  
Artery Pseudoaneurysm ◽  
Life Threatening

Fulminant post-tonsillectomy haemorrhage caused by aberrant course of the external carotid artery

2005 ◽  
Vol 119 (8) ◽  
pp. 655-657 ◽  
Author(s):  
Rutger Hofman ◽  
Clark J Zeebregts ◽  
Frederik G Dikkers
Keyword(s):  
Carotid Artery ◽  
Surgical Intervention ◽  
External Carotid Artery ◽  
External Carotid ◽  
Throat Pain ◽  
Life Threatening ◽  
Secondary Haemorrhage

Haemorrhage, throat pain and otalgia are common complications following tonsillectomy. Haemorrhage is rarely life-threatening but in this paper we describe a fulminant secondary haemorrhage due to an aberrant external carotid artery in an eight-year-old boy. Acute surgical intervention with ligation of the external carotid artery was needed to control the bleeding.

scholarly journals A TUMOR BIOPSY OF THE PARAPHARYNGEAL SPACE, COMPLICATED BY MASSIVE BLEEDING, WHICH REQUIRED URGENT TRACHEOSTOMY AND DRESSING OF THE EXTERNAL CAROTID ARTERY

2018 ◽  
Vol 17 (2) ◽  
pp. 100-102
Author(s):  
O. H. Plaksyvyy ◽  
I. V. Kalutsʹkyy ◽  
O. O. Mazur ◽  
M. M. Sorokhan
Keyword(s):  
Carotid Artery ◽  
Histological Examination ◽  
Rare Diseases ◽  
Rare Case ◽  
Clinical Case ◽  
Parapharyngeal Space ◽  
Massive Bleeding ◽  
External Carotid Artery ◽  
External Carotid ◽  
Tumor Biopsy

The article describes a rare case of rhabdomyoma parapharyngeal space. A peculiarity of the clinical case is the appearance after the biopsy of massive pharyngeal bleeding from the leak into the larynx, which required urgent tracheostomy and dressing of the external carotid artery. The tumor is removed by external access, a week after the elimination of complications. The result of histological examination is rhabdomyoma. The tumor of the parapharyngeal space occurs periodically, however rhabdomyomas are rare diseases.

scholarly journals Spontaneous Aneurysm of External Carotid Artery: Management and Complications

2018 ◽  
Vol 4 (02) ◽  
pp. 081-084
Author(s):  
Pankaj Banode ◽  
Abhinav A. Mohan ◽  
Shishir Ravekar ◽  
Priyanka Banode ◽  
Pushan Sharma
Keyword(s):  
Carotid Artery ◽  
Artery Aneurysm ◽  
External Carotid Artery ◽  
Laryngeal Edema ◽  
External Carotid ◽  
Extracranial Carotid Artery ◽  
Mortality And Morbidity ◽  
Carotid Artery Aneurysm ◽  
Life Threatening ◽  
Large Aneurysm

AbstractExtracranial carotid artery aneurysm is a rare vascular disease in the neck with variable presentation. Aneurysms are associated with significant mortality and morbidity and are associated with fatal complication secondary to spontaneous rupture or tracheal compression or laryngeal edema and distal embolization. A 43-year-old male patient presented with large aneurysm arising from proximal common carotid artery (CCA) causing tracheal obstruction leading to life-threatening respiratory symptoms. The endovascular interventional management is an emerging alternative for surgical option and providing promising results with almost similar safety and efficacy. Endovascular management of an extracranial carotid artery aneurysm using stent graft is minimally invasive and effective.

scholarly journals Intervening in the Acute Phase of Postradiation Carotid Blowout Syndrome

2019 ◽  
Vol 23 (02) ◽  
pp. 172-177 ◽  
Author(s):  
Marrigje A. de Jong ◽  
Carlos Candanedo ◽  
Menachem Gross ◽  
José E. Cohen
Keyword(s):  
Carotid Artery ◽  
Endovascular Procedures ◽  
Palliative Therapy ◽  
Surgical Excision ◽  
External Carotid Artery ◽  
External Carotid ◽  
Covered Stents ◽  
Carotid Blowout Syndrome ◽  
Life Years ◽  
Life Threatening

Introduction Acute carotid blowout syndrome (aCBS) is a severe complication of head and neck cancer (HNC). It can be defined as a rupture of the extracranial carotid arteries, or one of their branches, that causes life-threatening hemorrhage, and which nowadays can be treated with urgent endovascular intervention. Objective We retrospectively evaluate the endovascular management of aCBS and its outcome in years of survival. Methods Retrospectively, we describe our experience with endovascular control of aCBS in patients treated for HNC. We review the characteristics, pathology, endovascular treatment and morbidity and assess the gain in life years. Results Nine individuals were included in this study. Four patients had been previously diagnosed with laryngeal squamous cell carcinoma (SCC), one with paranasal SCC, one with nasopharyngeal carcinoma and three with oral or maxillary adenocarcinoma. All subjects underwent radiotherapy and surgical excision to different extents. Twelve endovascular procedures were performed for injuries to the internal carotid artery (n = 3; 25%), external carotid artery (n = 1; 7%) or one of their branches (n = 8; 67%). Deconstructive methods were used in nine procedures, and three procedures were mainly reconstructive with deployment of covered stents. Total control of bleeding was achieved in all individuals with no intraprocedural complications. Conclusion Endovascular therapy is an effective alternative for the management of exsanguinating CBS. In our series, this palliative therapy increased the overall patient survival by an estimated 9 months.

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