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颞下颌关节脱位手法复位后医源性颞浅动脉动静脉瘘

Iatrogenic arteriovenous fistula of the superficial temporal artery after manual reduction of temporomandibular joint dislocation.

作者信息

Takeuchi Satoru, Takasato Yoshio

机构信息

Department of Neurosurgery, National Defense Medical College, Saitama, Japan.

出版信息

J Craniofac Surg. 2011 Sep;22(5):1959-61. doi: 10.1097/SCS.0b013e31822ea814.

Abstract

A 33-year-old man fell from a height and was referred to our hospital. Physical examination showed a swelling in the left preauricular region without laceration. No thrill or bruit was detected at this time. A face x-ray and a computed tomographic scan showed a left temporomandibular joint (TMJ) dislocation, Le Fort I fractures, and a mandibular body fracture. Left TMJ dislocation was treated by manual reduction. Two days after admission, a swelling in the left preauricular region progressed, with thrill and bruit. Left external carotid artery angiograms showed an arteriovenous fistula with a dilated pouch near the left TMJ. The fistula was fed by the left superficial temporal artery and drained into the left superficial temporal vein. The fistula was successfully embolized using Tornado coils. This is the first case of an arteriovenous fistula of the superficial temporal artery after manual reduction of TMJ dislocation.

摘要

一名33岁男性从高处坠落,被转诊至我院。体格检查发现左耳前区肿胀,无裂伤。此时未触及震颤或杂音。面部X线和计算机断层扫描显示左侧颞下颌关节(TMJ)脱位、Le Fort I型骨折和下颌体骨折。左侧TMJ脱位采用手法复位治疗。入院两天后,左耳前区肿胀加重,出现震颤和杂音。左侧颈外动脉血管造影显示在左侧TMJ附近有一个动静脉瘘,伴有一个扩张的囊袋。该瘘由左侧颞浅动脉供血,引流至左侧颞浅静脉。使用弹簧圈成功栓塞了该瘘。这是颞下颌关节脱位手法复位后颞浅动脉动静脉瘘的首例病例。

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