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Oral and Maxillofacial Surgery

20-11-2023 | Epistaxis | Case Report

Management of pseudoaneurysms of the internal maxillary artery derived from orthognathic surgery based on one case

Authors: Gonzalo Botella-Casas, Mariano Marqués-Mateo, Luis Miragall-Alba, Daniela María Río-Vega, Eva González-Soler, Miguel Puche-Torres

Published in: Oral and Maxillofacial Surgery

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Abstract

Purpose

The purpose of this article is to highlight the risk of pseudoaneurysms formation after orthognathic surgery, their clinical features and management.

Methods

A case report of a 24-year-old man who suffered a pseudoaneurysm of the internal maxillary artery after sagittal osteotomy during orthognathic is reported. After three bleeding episodes, a pseudoaneurysm was diagnosed with a computed tomography angiogram (CTA) and treated with an embolization of the internal maxillary artery with polyvinyl alcohol (PVA) successfully.

Results

Pseudoaneurysms derived from the external carotid artery are an uncommon complication of orthognathic surgery, especially related to sagittal osteotomy instead of LeFort I osteotomy.

Conclusion

Pseudoaneurysms derived from external carotid artery branches must be suspected when patients show multiple episodes of bleeding (epistaxis or through the surgical approach) within the first two weeks after orthognathic surgery. If so, vascular CT or angiography should be performed to rule out the presence of vascular injuries. In case a pseudoaneurysm is identified, vascular embolization with N-butyl-cyanoacrylate seems to be the best treatment if available. If this treatment is not available or bleeding cannot be controlled, surgical ligature of the injured vessel is a valid treatment.
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Metadata
Title
Management of pseudoaneurysms of the internal maxillary artery derived from orthognathic surgery based on one case
Authors
Gonzalo Botella-Casas
Mariano Marqués-Mateo
Luis Miragall-Alba
Daniela María Río-Vega
Eva González-Soler
Miguel Puche-Torres
Publication date
20-11-2023
Publisher
Springer Berlin Heidelberg
Keyword
Epistaxis
Published in
Oral and Maxillofacial Surgery
Print ISSN: 1865-1550
Electronic ISSN: 1865-1569
DOI
https://doi.org/10.1007/s10006-023-01197-9