Ribeiro André L R, Silva Walessa B, Menezes Sílvio A F, Kataoka Maria S S, Alves Sérgio M, Pinheiro João J V
From the *Department of Oral and Maxillofacial Surgery, School of Dentistry, University Center of Pará-CESUPA; †School of Dentistry, University Center of Pará; ‡Department of Periodontology, School of Dentistry, University Center of Pará-CESUPA; §Department of Oral Pathology, School of Dentistry, Federal University of Pará-UFPA; and ∥Department of Oral Pathology, School of Dentistry, University Center of Pará-CESUPA, Belém, Brazil.
J Craniofac Surg. 2014 Jan;25(1):e61-5. doi: 10.1097/SCS.0b013e3182a4c6b9.
Vascular injuries are a constant risk in facial trauma, although bone and soft tissues of the face have provided some protection to the larger blood vessels. However, penetrating injuries usually do not have this type of protection and can damage significant vascular arteries. This article presents a case of a stab wound, which led to airway obstruction arising to a large sublingual hematoma due to lingual artery injury. A healthy 44-year-old man was stabbed in the submandibular region and admitted with an airway obstruction. He was subjected to an emergency tracheotomy and evolved with progressive sublingual edema. Computed tomography (CT) angiography showed a left lingual artery injury with the formation of an expansive hematoma. The CT angiography findings helped to identify the cause of the hematoma and guided the surgery to drain the hematoma after ligation of the lingual artery. The treatment was safely performed as planned and evolved uneventfully. The patient recovered fast and well and presented normal functions 6 months after the treatment. This surgical technique is an effective method for treating such injuries because it can be safely performed when guided by CT angiography. The authors argue that the demand for vascular lesions should be routine in patients who have facial trauma.
血管损伤是面部创伤中持续存在的风险，尽管面部的骨骼和软组织为较大的血管提供了一定的保护。然而，穿透性损伤通常没有这种保护，可能会损伤重要的血管动脉。本文介绍了一例刺伤病例，该刺伤导致舌动脉损伤，进而引发巨大舌下血肿，导致气道阻塞。一名44岁的健康男性在颌下区域被刺伤，因气道阻塞入院。他接受了紧急气管切开术，并出现了进行性舌下水肿。计算机断层扫描（CT）血管造影显示左舌动脉损伤并形成扩展性血肿。CT血管造影结果有助于确定血肿的原因，并指导在结扎舌动脉后进行手术引流血肿。治疗按计划安全进行，过程顺利。患者恢复迅速且良好，治疗6个月后功能正常。这种手术技术是治疗此类损伤的有效方法，因为在CT血管造影的引导下可以安全地进行。作者认为，对于面部创伤患者，血管损伤的检查应常规进行。
