Kim Jun Hyuk, Yoon Seok Mann, Choi Hwan Jun
From the Departments of *Plastic & Reconstructive Surgery and †Neurosurgery, College of Medicine, Soonchunhyang University Hospital, Cheonan, Korea.
J Craniofac Surg. 2015 Jan;26(1):e50-1. doi: 10.1097/SCS.0000000000001312.
A 34-year-old woman who had a history of undergoing reduction malarplasty at a local clinic about 1 year ago developed gradually increasing pulsatile tinnitus in the right preauricular area since the last 6 months. On physical examination, there were an approximately 1 × 0.5-cm nontender, soft, pulsatile mass with a palpable thrill and a continuous machinery-like buzzing sound in synchrony with the heartbeat. She had a fine scar near the mass, which was supposed to be a postoperative scar of reduction malarplasty. A three-dimensional computed tomographic angiogram revealed a direct arteriovenous fistula between the superficial temporal artery and superficial temporal vein in the right preauricular area. The arteriovenous fistula was embolized using Tornado coils. After coiling, the thrill and disturbing tinnitus disappeared immediately, and postembolization angiography confirmed obliteration of the arteriovenous shunt. This is the first case of an arteriovenous fistula of the superficial temporal artery after reduction malarplasty, and it indicates that arteriovenous fistula can occur as a delayed complication of reduction malarplasty.
一名34岁女性，约1年前在当地诊所接受了颧骨缩小整形手术，自6个月前起，其右耳前区域逐渐出现搏动性耳鸣且症状不断加重。体格检查发现，右耳前区域有一个大小约为1×0.5厘米的无压痛、柔软、搏动性肿物，可触及震颤，并有与心跳同步的连续性机器样嗡嗡声。肿物附近有一条细小瘢痕，推测为颧骨缩小整形术后的瘢痕。三维计算机断层血管造影显示，右耳前区域颞浅动脉与颞浅静脉之间存在直接动静脉瘘。采用弹簧圈对动静脉瘘进行了栓塞治疗。栓塞后，震颤和令人困扰的耳鸣立即消失，栓塞后血管造影证实动静脉分流已闭塞。这是颧骨缩小整形术后颞浅动脉动静脉瘘的首例报道，提示动静脉瘘可能作为颧骨缩小整形术的迟发性并发症出现。
