Kanke Kosuke, Abe Takahiro, Abe Masanobu, Mori Yoshiyuki, Hoshi Kazuto, Takato Tsuyoshi
Department of Oral and Maxillofacial Surgery, Dentistry and Orthodontics, The University of Tokyo Hospital, Hongo 7-3-1 Bunkyo-ku, Tokyo, 113-8655, Japan.
Department of Dentistry, Oral and Maxillofacial Surgery, Jichi Medical University, Yakushiji 3311-1, Shimotsuke-shi, Tochigi, 329-0498, Japan.
Ann Med Surg (Lond). 2017 Oct 13;24:15-18. doi: 10.1016/j.amsu.2017.10.001. eCollection 2017 Dec.
In East Asia, a square face is considered unattractive, and mandibular contouring surgery is commonly used to give a smooth contour to the lower jaw. Mandibular contouring surgery occasionally involves not only osteotomy of the mandibular angle but also resection of the masseter muscle via an intraoral approach. This type of mandibular contouring surgery poses a risk of injury to the premasseteric branch of the facial artery and massive haemorrhage. Here we report a patient who presented to our hospital with severe haemorrhage, swelling and airway constriction after bilateral mandibular angle and plane osteotomy with resection of the masseter muscle performed elsewhere as an office-based day surgery. The swelling and haemorrhage were treated successfully with emergency bilateral ligation of the facial artery and vein under general anaesthesia. We concluded that the haemorrhage was caused by rupture of the premasseteric branch of the facial artery during the resection of the masseter muscle in a day surgery.
在东亚地区,方形脸被认为缺乏吸引力,下颌轮廓整形手术常用于使下颌轮廓变得平滑。下颌轮廓整形手术偶尔不仅涉及下颌角截骨,还需通过口内入路切除咬肌。这类下颌轮廓整形手术存在损伤面动脉咬肌前分支及大出血的风险。在此,我们报告一名患者,其在其他地方作为日间门诊手术接受双侧下颌角及平面截骨并切除咬肌后,因严重出血、肿胀和气道狭窄前来我院就诊。在全身麻醉下紧急双侧结扎面动脉和静脉后,肿胀和出血得到成功治疗。我们得出结论,出血是由日间手术中咬肌切除过程中面动脉咬肌前分支破裂所致。