Jo H-W, Kim Y-S, Kang D-H, Lee S-H, Kwon T-G
Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Samduck 2 Ga, Jung Gu, Daegu, South Korea.
Oral Maxillofac Surg. 2013 Jun;17(2):151-4. doi: 10.1007/s10006-012-0339-4. Epub 2012 Aug 2.
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.
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.
假性动脉瘤是由动脉破裂伴血液外渗引起的。受压的血管周围组织形成动脉瘤囊壁。与矢状劈开下颌支截骨术(SSRO)手术直接相关的假性动脉瘤报道很少,尤其是在垂直截骨过程中与面动脉相关的情况。
对一名19岁男性实施了SSRO;患者在术后3周因明显肿胀就诊于急诊室。手术探查时我们遇到了严重的口腔内出血。血管造影显示右面部动脉假性动脉瘤,可能与正颌手术中下颌体外侧皮质的垂直截骨有关。这意味着传统正颌手术中下颌体垂直截骨造成的轻微血管损伤可能导致后期假性动脉瘤的形成。