Misra Shantum, Haas Corbett A, August Meredith, Eberlin Kyle R
Medical Student, George Washington University School of Medicine and Health Sciences, Washington, DC.
Resident Physician, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
J Oral Maxillofac Surg. 2016 Jan;74(1):123-8. doi: 10.1016/j.joms.2015.09.013. Epub 2015 Sep 25.
Traumatic injuries to the lip are common, but injuries that require revascularization of the lower lip are infrequent and pose a major challenge to the reconstructive surgeon. This report describes the case of a 53-year-old woman who sustained a lower lip avulsion injury, a comminuted mandibular parasymphyseal fracture, and a hyoid bone fracture secondary to a bicycle accident. Trauma workup included computed tomographic angiography of the head and neck, which did not show vascular injury. Despite successful revascularization of the lower lip, on postoperative day 11 the patient developed a large internal carotid artery dissection and middle cerebral artery stroke. This case highlights the importance of careful postoperative monitoring after high-energy facial trauma, particularly in the setting of vascular and bony injuries.
唇部创伤很常见，但需要对下唇进行血管重建的损伤并不常见，对重建外科医生构成了重大挑战。本报告描述了一名53岁女性的病例，她因自行车事故导致下唇撕脱伤、下颌骨正中旁粉碎性骨折和舌骨骨折。创伤检查包括头颈部计算机断层血管造影，未显示血管损伤。尽管下唇血管重建成功，但术后第11天患者发生了大面积颈内动脉夹层和大脑中动脉卒中。该病例强调了高能面部创伤后仔细术后监测的重要性，特别是在存在血管和骨损伤的情况下。
