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Drevik J, Ellis JL, Swerdloff D, Higgins A, Simhan J. Profound facial bleeding after buccal mucosa graft harvest – A rare case of facial artery pseudoaneurysm. Urol Case Rep 2022; 44:102155. [PMID: 35846517 PMCID: PMC9283873 DOI: 10.1016/j.eucr.2022.102155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 06/24/2022] [Accepted: 07/01/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- Johnathan Drevik
- Department of Urology, Einstein Healthcare Network, Philadelphia, PA, USA
- Corresponding author.
| | - Jeffrey L. Ellis
- Department of Urology, Einstein Healthcare Network, Philadelphia, PA, USA
| | - Daniel Swerdloff
- Department of Urology, Einstein Healthcare Network, Philadelphia, PA, USA
- Division of Urologic Oncology, Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Andrew Higgins
- Department of Urology, Einstein Healthcare Network, Philadelphia, PA, USA
| | - Jay Simhan
- Department of Urology, Einstein Healthcare Network, Philadelphia, PA, USA
- Division of Urologic Oncology, Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
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Kuang R, Zhou J, Deng J, Xia T, Li M. Case Report: A Case of a Child With Facial Foreign Body Abscess and Facial Artery Pseudoaneurysm. Front Pediatr 2022; 10:886031. [PMID: 35573965 PMCID: PMC9095982 DOI: 10.3389/fped.2022.886031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 04/05/2022] [Indexed: 11/13/2022] Open
Abstract
Facial artery pseudoaneurysms are rare and mostly a result of blunt injury. Since the facial arteries are well protected by facial soft tissue and the lumen of the facial artery is thin and small in diameter, a sharp injury usually leads to complete transection rather than partial laceration of the blood vessel. As a non-invasive method, ultrasound does not involve radiation and sedation. Diagnosis of facial artery pseudoaneurysms is most commonly made with ultrasound, and Doppler ultrasound is essential. On grayscale imaging, facial artery pseudoaneurysms often appearanced of a fluid collection, Color Doppler imaging often show a well-defined swirl pattern named "yin and yang sign," the Spectral Doppler showed a diagnostic "to and fro" two-phase bidirectional arterial blood flow spectrum. It's particularly for the examination of facial artery pseudoaneurysms in children. Here, we report a case of facial foreign body abscess and facial artery pseudoaneurysm in a 19-month-old child 1 week after a sharpness injury that was diagnosed by ultrasound.
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Affiliation(s)
- Rong Kuang
- Department of Ultrasound, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Jing Zhou
- Department of Ultrasound, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Jiaqi Deng
- Department of Ultrasound, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Tian Xia
- Department of Pathology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Mingxing Li
- Department of Ultrasound, The Affiliated Hospital of Southwest Medical University, Luzhou, China
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Kumar A, Kaur A, Singh M, Rattan V, Rai S. "Signs and Symptoms Tell All"-Pseudoaneurysm as a Cause of Postoperative Bleeding after Orthognathic Surgery-Report of a Case and a Systematic Review of Literature. J Maxillofac Oral Surg 2021; 20:345-355. [PMID: 34408361 PMCID: PMC8313620 DOI: 10.1007/s12663-020-01476-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 10/27/2020] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Pseudoaneurysms are one of the rare complications that can be encountered after the orthognathic surgery. We are presenting a new case of pseudoaneurysm of bilateral sphenopalatine artery after Bijaw Surgery in a young male and a systematic review of all the cases in the literature emphasizing on signs and symptoms, epistaxis or bleeding episodes and treatment outcomes. METHODS A systematic research strategy was planned according to the PRISMA guidelines, and articles were taken from 1986 to September, 2019. A total of 899 articles were selected for screening, out of which only 26 articles met our inclusion and exclusion criteria. These were included in the study for qualitative analysis. RESULTS Most PAs were associated with Lefort I osteotomy (69.7%), followed by sagittal split osteotomy (24.24%). Average intraoperative blood was 635 ml. Maximum number of episodes of epistaxis/swelling or bleeding occurred in second week. Mean bleeding episodes were 2.58 ± 0.996. The arteries commonly affected were internal maxillary artery (42%), sphenopalatine artery (27.27%), facial artery (15.15%), descending palatine artery (12.12%), internal carotid artery (9.09%) and infraorbital artery (3.03%). Embolization was treatment of choice in 81.81% cases. CONCLUSION If a patient has recurrent epistaxis or swelling after orthognathic surgery, it is advisable to go for diagnostic imaging like angiography without any delay. In recent times, advanced techniques and expertise are readily available for early diagnosis and management of pseudoaneurysm.
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Affiliation(s)
- Arun Kumar
- Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Amanjot Kaur
- Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Manpreet Singh
- Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Vidya Rattan
- Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Sachin Rai
- Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
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Roy S, Jain N. The Presentation and Management of Facial Artery Pseudoaneurysm: A Review of the Literature. Turk Arch Otorhinolaryngol 2021; 59:76-79. [PMID: 33912864 PMCID: PMC8054931 DOI: 10.4274/tao.2020.5594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 12/07/2020] [Indexed: 12/01/2022] Open
Abstract
Pseudoaneurysm is a rare vascular complication of trauma, causing an incomplete tear of the vessel wall. We present a clinical case report arising from the distal branch of facial artery in an infant. Facial artery pseudoaneurysm is a rare complication of facial trauma and can easily be misdiagnosed especially in the paediatric age group. Prompt investigation and diagnosis with timely and apt intervention is the key to the successful management of facial artery pseudoaneurysm.
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Affiliation(s)
- Suparna Roy
- Department of Otorhinolaryngology, Chacha Nehru Bal Chikitsalaya Hospital, Delhi, India
| | - Neha Jain
- Department of Otorhinolaryngology, Chacha Nehru Bal Chikitsalaya Hospital, Delhi, India
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Nakagawa K, Yasuda T, Kobayashi N, Urabe K. Huge true aneurysm of the facial artery treated with internal trapping and surgical excision: a case report. J Surg Case Rep 2020; 2020:rjaa375. [PMID: 33024536 PMCID: PMC7526470 DOI: 10.1093/jscr/rjaa375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 08/09/2020] [Accepted: 08/18/2020] [Indexed: 11/14/2022] Open
Abstract
A report of true aneurysms is extremely rare. There are only five previous case reports of true aneurysm of the facial artery. In the previously reported cases, there was no case that underwent trapping and surgical excision. In this case report, we describe the procedure of internal trapping before the surgical excision of a huge true aneurysm of the right facial artery for a 79-year-old woman. There was no recurrence of the aneurysm during a 6-month follow-up period.
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Affiliation(s)
- Kiyoko Nakagawa
- Department of Oral and Maxillofacial Surgery, Yao Tokushukai General Hospital, Osaka, Japan
| | - Takuji Yasuda
- Department of Oral and Maxillofacial Surgery, Sakai City Hospital, Osaka, Japan
| | - Natsuko Kobayashi
- First Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, Osaka, Japan
| | - Kazuhiko Urabe
- Department of Oral and Maxillofacial Surgery, Yao Tokushukai General Hospital, Osaka, Japan
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6
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Amin D, Satishchandran S, Hamilton JM, Grossberg JA, Abramowicz S. Management of Post-Traumatic Maxillofacial Pseudoaneurysms: Review of the Literature and Suggested Algorithm. J Oral Maxillofac Surg 2020; 78:2008.e1-2008.e9. [PMID: 32771443 DOI: 10.1016/j.joms.2020.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/09/2020] [Accepted: 07/09/2020] [Indexed: 11/28/2022]
Abstract
A pseudoaneurysm (PA) is a collection of blood caused by an incomplete tear in the vessel wall. PA can be arterial or venous in origin. In the maxillofacial region, arterial PA can result from surgical interventions. Venous PAs in the maxillofacial region have never been described. A standardized protocol for management of post-traumatic PAs in the maxillofacial region would help clinicians make treatment decisions. On the basis of the available literature and our institutional experience, we present an algorithm for management of post-traumatic maxillofacial PAs. We also present patients from our institution who illustrate some of the management options in the algorithm.
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Affiliation(s)
- Dina Amin
- Assistant Professor, Oral and Maxillofacial Surgery, Emory University School of Medicine, Director of Oral and Maxillofacial Surgery Outpatient Clinic, Grady Memorial Hospital, Atlanta, GA.
| | - Sruthi Satishchandran
- Resident-in-Training, Oral and Maxillofacial Surgery, Emory University School of Medicine, Atlanta, GA
| | - James M Hamilton
- Assistant Professor, Otolaryngology, Emory University School of Medicine, Grady Memorial Hospital, Atlanta, GA
| | - Jonathan A Grossberg
- Assistant Professor, Neurosurgery, Emory University School of Medicine, Grady Memorial Hospital, Atlanta, GA
| | - Shelly Abramowicz
- Associate Professor, Oral and Maxillofacial Surgery and Pediatrics, Emory University, School of Medicine, Chief of Oral and Maxillofacial Surgery, Children's Healthcare of Atlanta, Atlanta, GA
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Al-Saadi NJ, Bakathir A, Al-Mashaikhi A, Al-Hashmi A, Al-Habsi A, Al-Azri F. Maxillary Artery Pseudoaneurysm as a Complication of Maxillofacial Injuries: Report of three cases and literature review. Sultan Qaboos Univ Med J 2019; 19:e364-e368. [PMID: 31897321 PMCID: PMC6930039 DOI: 10.18295/squmj.2019.19.04.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 08/26/2019] [Accepted: 09/19/2019] [Indexed: 11/16/2022] Open
Abstract
Traumatic maxillary artery pseudoaneurysm is an uncommonly reported complication in the field of oral and maxillofacial surgery. It is usually discovered incidentally, either early after trauma or weeks-to-months later. Quick recognition and prompt management are essential to avoid devastating consequences. In this paper, we report three uncommon cases of maxillary artery pseudoaneurysm recognised during the surgical management of maxillofacial injuries in Muscat, Oman. All cases presented as sudden brisk bleeding during the intraoperative surgical repair and were subsequently diagnosed and successfully managed by endovascular embolisation with platinum coils. This case report highlights the clinical presentation, diagnosis and management of maxillary artery pseudoaneurysm, in addition to a brief review of the literature.
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Affiliation(s)
- Noor J Al-Saadi
- Department of General Surgery, Al Rustaq Hospital, Al Rustaq, Oman
| | - Abdulaziz Bakathir
- Department of Dental & Maxillofacial Surgery, Sultan Qaboos University Hospital, Muscat, Oman
| | - Ali Al-Mashaikhi
- Oral and Maxillofacial Surgery Program, Oman Medical Specialty Board, Muscat, Oman
| | - Ahmed Al-Hashmi
- Department of Dental and Maxillofacial Surgery, Al Nahda Hospital, Muscat, Oman
| | | | - Faisal Al-Azri
- Department of Radiology & Molecular Imaging, Sultan Qaboos University Hospital, Muscat, Oman
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Neto TJDL, Maranhão CADA, Neto PJDO. Pseudoaneurysm of Facial Artery After Orthognathic Surgery. J Craniofac Surg 2019; 30:e607-e609. [DOI: 10.1097/scs.0000000000005696] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Maleux O, da Costa Senior O, Politis C, Maleux G. Glue embolisation of a bleeding pseudoaneurysm related to surgically-assisted rapid palatal expansion. Br J Oral Maxillofac Surg 2019; 57:597-599. [PMID: 31155397 DOI: 10.1016/j.bjoms.2019.02.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 02/01/2019] [Indexed: 11/19/2022]
Abstract
Vascular injuries after orthognathic surgery are rare, and mainly occur in young adults after Le Fort I osteotomies. We report the case of a 14-year-old girl who presented with life-threatening epistaxis one week after a surgically-assisted rapid palatal expansion (SARPE) followed by activation of a transpalatal distractor. Definitive treatment was superselective, catheter-directed, glue-embolisation of a bleeding bilobar pseudoaneurysm, which was located at an end branch of the left sphenopalatine artery.
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Affiliation(s)
- O Maleux
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - O da Costa Senior
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - C Politis
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - G Maleux
- Department of Radiology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
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Dudaryk R, Horn DB, Green JM. Facial Artery Pseudoaneurysm: Challenges of Airway Management. Anesth Prog 2018; 65:52-55. [PMID: 29509524 DOI: 10.2344/anpr-65-02-09] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
A patient with recent jaw reconstruction presented for treatment of postoperative oropharyngeal hemorrhage. Asleep nasal fiberoptic intubation was attempted, but a rare and unanticipated complication ensued: rupture of right facial artery pseudoaneurysm. The difficult airway algorithm was followed up to the point of surgical airway. While nasal or oral fiberoptic intubation is often perceived as the safest approach for management of a difficult airway, we discuss alternative treatment strategies for patients with a facial pseudoaneurysm. Such alternatives include preoperative angiographic endovascular embolization of the vessel(s) feeding the pseudoaneurysm, and/or elective tracheostomy.
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Affiliation(s)
- Roman Dudaryk
- Department of Anesthesiology, University of Miami Miller School of Medicine, Miami, Florida
| | - Danielle B Horn
- Department of Anesthesiology, University of Miami Miller School of Medicine/Jackson Memorial Hospital, Miami, Florida
| | - J Marshall Green
- Oral and Maxillofacial Surgery, University of Miami Miller School of Medicine, Miami, Florida; Uniformed Services University of the Health Sciences, Bethesa, Maryland; Naval Medical Center Portsmouth, Portsmouth, Virginia
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11
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Anand L, Sealey C. Pseudoaneurysm of the facial artery following bilateral temporomandibular joint replacement: A case report. ORAL AND MAXILLOFACIAL SURGERY CASES 2017. [DOI: 10.1016/j.omsc.2017.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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12
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Kim YK. Complications associated with orthognathic surgery. J Korean Assoc Oral Maxillofac Surg 2017; 43:3-15. [PMID: 28280704 PMCID: PMC5342970 DOI: 10.5125/jkaoms.2017.43.1.3] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 02/09/2017] [Indexed: 11/21/2022] Open
Abstract
While most patients undergo orthognathic surgery for aesthetic purposes, aesthetic improvements are most often followed by postoperative functional complications. Therefore, patients must carefully decide whether their purpose of undergoing orthognathic surgery lies on the aesthetic side or the functional side. There is a wide variety of complications associated with orthognathic surgery. There should be a clear distinction between malpractice and complications. Complications can be resolved without any serious problems if the cause is detected early and adequate treatment provided. Oral and maxillofacial surgeons must have a full understanding of the types, causes, and treatment of complications, and should deliver this information to patients who develop these complications.
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Affiliation(s)
- Young-Kyun Kim
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
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Mitsukawa N, Morishita T, Saiga A, Kubota Y, Omori N, Akita S, Satoh K. Dislocation of temporomandibular joint: complication of sagittal split ramus osteotomy. J Craniofac Surg 2015; 24:1674-5. [PMID: 24163864 DOI: 10.1097/scs.0b013e31828f2812] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Sagittal split ramus osteotomy (SSRO) has wide-ranging indications and results in simultaneous improvements in occlusion and facial appearance. Thus, it is the most frequently used osteotomy for jaw deformities. Its main intraoperative and postoperative complications are massive bleeding, atypical fractures, inferior alveolar nerve paralysis, and relapse. This report describes a case of temporomandibular joint dislocation, a rare complication of SSRO. The patient was a 23-year-old man with mandibular prognathism which was treated by bilateral SSRO. Postoperative x-ray showed that the left temporomandibular joint was dislocated anteriorly. Thus, the patient underwent reoperation, including reduction and re-fixation. Subsequently, it was discovered that the patient had a previous history of recurrent dislocation of the temporomandibular joint. This case illustrates the need for practitioners to be mindful of temporomandibular joint dislocation as a rare complication of SSRO.
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Katakol B, Govindaraj E. Pseudoaneurysm of the internal maxillary artery following mandibular condylar fracture. Ann Maxillofac Surg 2015; 4:201-4. [PMID: 25593875 PMCID: PMC4293846 DOI: 10.4103/2231-0746.147143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Pseudoaneurysm of the internal maxillary artery is a rare occurrence. A well-organized pulsatile mass that develops after a traumatic event indicates a pseudoaneurysm. Such lesions are commonly misdiagnosed for an abscess or a hematoma. Pulsations and audible bruit are diagnostic features of an aneurysm. Rupture of such false aneurysms cause significant morbidity. Management is either surgical resection or embolization. Endovascular embolization is indicated in deep seated lesions or lesions with high morbidity. Though surgical resection is an invasive procedure, it is considered to be an alternative to embolization.
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Affiliation(s)
- Basavaraj Katakol
- Department of Oral and Maxillofacial Surgery, Government Dental College and Research Institute, Bellary, Karnataka, India
| | - E Govindaraj
- Department of Surgical Oncology, Vijayanagar Institute of Medical Sciences, Bellary, Karnataka, India
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Pseudoaneurysm of the facial artery occurred after mandibular sagittal split ramus osteotomy. Oral Maxillofac Surg 2012; 17:151-4. [PMID: 22855307 PMCID: PMC3661081 DOI: 10.1007/s10006-012-0339-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Accepted: 07/16/2012] [Indexed: 11/30/2022]
Abstract
Introduction Pseudoaneurysms are caused by rupture of arteries with extravasation of blood. The compressed perivascular tissue forms the wall of aneurysmal sac. Pseudoaneurysm directly related with surgical procedure of sagittal split ramus osteotomy (SSRO) was reported quite rarely especially related with facial artery during the vertical osteotomy. Case report SSRO was carried out for a 19-year-old male; the patient visited the emergency room with notable swelling 3 weeks after the surgery. We experienced severe intra-oral bleeding with surgical exploration. Angiography revealed a pseudoaneurysm of the right facial artery that might be related with vertical osteotomy over lateral cortex of the mandibular body during orthognathic surgery. This implies that the minor vascular trauma from vertical osteotomy of the mandibular body during the conventional orthognathic surgery might cause later development of pseudoaneurysm.
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Steel BJ, Cope MR. Unusual and Rare Complications of Orthognathic Surgery: A Literature Review. J Oral Maxillofac Surg 2012; 70:1678-91. [DOI: 10.1016/j.joms.2011.05.010] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Revised: 05/03/2011] [Accepted: 05/09/2011] [Indexed: 10/17/2022]
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Endovascular management of postoperative pseudoaneurysms of the external carotid artery. J Clin Neurosci 2012; 19:649-54. [PMID: 22502912 DOI: 10.1016/j.jocn.2011.11.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Accepted: 11/03/2011] [Indexed: 11/22/2022]
Abstract
Hemorrhage secondary to postoperative pseudoaneurysm is a rare event, but may complicate the clinical course of straightforward and common interventions such as sinonasal procedures, tonsillectomy, and maxillofacial and plastic surgeries. We report our experience with the endovascular management of iatrogenic pseudoaneurysm in eight patients who had undergone recent craniomaxillofacial surgery. Computed tomography (CT), including CT-angiography, detected only three of the eight lesions. In all patients, endovascular embolization achieved successful occlusion of the pseudoaneurysm without local or general procedure-related complications. Immediate proximal arterial occlusion with detachable coils was performed in every case, and pseudoaneurysm coiling was performed in three cases presenting with active hemorrhage. Endovascular therapy proved to be safe and effective in the management of postoperative pseudoaneurysms. Surgeons involved in the craniomaxillofacial procedures should be aware of this complication and its management.
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Precious DS, Powell JE, Tuzuner AM, Schmidt M, Doucet JC, Vandorpe R. False Aneurysms After Sagittal Split Ramus Osteotomies. J Oral Maxillofac Surg 2012; 70:e58-65. [DOI: 10.1016/j.joms.2011.09.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Revised: 08/31/2011] [Accepted: 09/03/2011] [Indexed: 10/14/2022]
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Ribeiro-Ribeiro AL, de Melo Alves Junior S, de Jesus Viana Pinheiro J. Traumatic pseudoaneurysm of the facial artery: late complication and effects on local blood flow. ACTA ACUST UNITED AC 2011; 112:e4-9. [PMID: 21669358 DOI: 10.1016/j.tripleo.2011.03.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2011] [Revised: 03/08/2011] [Accepted: 03/08/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Pseudoaneurysms are vascular injuries resulting from a rupture of the vessel walls with blood extravasation into perivascular tissues. Proper treatment is required to prevent rupture and intense bleeding. This article reports a case of pseudoaneurysm of the facial artery that evolved to a late complication, presenting dehiscence of suture and exposure of the wound and bleeding after the initial injury and also discusses the effects of vascular response from the involved vessels by comparing them against the contralateral side. CASE REPORT A healthy 17-year-old male was admitted with an injury of approximately 35 mm in length in the right cheek with an exposed clot inside the injury and local bleeding after a stabbing 11 days before. CT angiography showed rupture of the facial artery and formation of a pseudoaneurysm with an organized clot. The patient was treated by means of surgery under local anesthesia and intravenous sedation. The facial artery was located and attached by suture. The wound was explored and clots were removed. The patient was discharged on the first postoperative day and he had an excellent scarring standard with no unfavorable event. CONCLUSIONS The authors conclude that this surgical technique is an effective method for treating such injuries, as it is easily performed and can be conducted by the oral and maxillofacial surgeon assistant.
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Affiliation(s)
- André Luis Ribeiro-Ribeiro
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University Center of Pará-CESUPA, Belém, Brazil.
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Pseudoaneurysm of the facial artery as a complication of the sagittal split osteotomy. ACTA ACUST UNITED AC 2010; 110:683; author reply 683-4. [PMID: 21112527 DOI: 10.1016/j.tripleo.2010.07.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2010] [Accepted: 07/22/2010] [Indexed: 11/23/2022]
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