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KMID : 1033720220230020089
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Archives of Craniofacial Surgery
2022 Volume.23 No. 2 p.89 ~ p.92
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Ruptured pseudoaneurysm of the internal maxillary artery in zygomaticomaxillary fracture: a case report
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Lim Soo-Yeon
Lee Hyun-Gun
Kim Kyu-Nam
Kim Hoon
Oh Dong-Hyun
Koh In-Chang
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Abstract
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Post-traumatic pseudoaneurysms of internal maxillary artery are rare, but may be life-threatening. When arterial damage leads to pseudoaneurysm formation, delayed intractable epistaxis can occur. We report our experience with the diagnosis and management of a ruptured internal maxillary arterial pseudoaneurysm that was discovered preoperatively in a patient with a zygomaticomaxillary complex (ZMC) fracture. He presented to the emergency room with epistaxis, which ceased shortly, and sinus hemorrhage was observed with a fracture of the posterior maxillary wall. The patient was scheduled for open reduction and internal fixation (ORIF) of the ZMC fracture. However, immediately before surgery, uncontrolled epistaxis of unknown origin was observed. Angiography indicated a pseudoaneurysm of the posterior superior alveolar artery. Selective endovascular embolization was performed, and hemostasis was achieved. After radiologic intervention, ORIF was successfully implemented without complications. Our case shows that in patients with a posterior maxillary wall fracture, there is a risk of uncontrolled bleeding in the perioperative period that could be caused by pseudoaneurysms, which should be considered even in the absence of typical symptoms.
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KEYWORD
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Aneurysm, Case reports, False, Epistaxis, Perioperative period
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