Chun Jeong Jin, Choi Chang Yong, Wee Syeo Young, Song Woo Jin, Jeong Hyun Gyo
Department of Plastic and Reconstructive Surgery, Soonchunhyang University College of Medicine, Gumi, Korea.
Department of Plastic and Reconstructive Surgery, Soonchunhyang University College of Medicine, Bucheon, Korea.
Arch Craniofac Surg. 2019 Aug;20(4):251-254. doi: 10.7181/acfs.2019.00227. Epub 2019 Aug 20.
Posttraumatic pseudoaneurysms of the sphenopalatine artery are rare. Only a few cases have been reported. We report two cases of hemorrhage due to pseudoaneurysm of the sphenopalatine artery. The hemorrhage was uncontrollable. It required embolization. Two patients visited our hospital for treatment of zygomaticomaxillary complex fracture. At the emergency room, patients presented with massive nasal bleeding which ceased shortly. After reduction of the fracture, patients presented persistent nasopharyngeal bleeding. Under suspicion of intracranial vessel injury, we performed angiography. Angiograms revealed pseudoaneurysms of the sphenopalatine artery. Endovascular embolization was performed, leading to successful hemostasis in both patients. Due to close proximity to pterygoid plates, zygomaticomaxillary complex fracture involving pterygoid plates may cause injury of the sphenopalatine artery. The only presentation of sphenopalatine artery injury is nasopharyngeal bleeding which is common. Based on our clinical experience, although pseudoaneurysm of maxillary artery branch after maxillofacial trauma has a low incidence, suspicion of injury involving deeply located arteries and early imaging via angiogram are recommended to manage recurrent bleeding after facial trauma or surgery.
蝶腭动脉创伤后假性动脉瘤较为罕见。仅有少数病例被报道。我们报告两例因蝶腭动脉假性动脉瘤导致的出血病例。出血难以控制，需要进行栓塞治疗。两名患者因颧上颌复合体骨折前来我院就诊。在急诊室，患者出现大量鼻出血，但很快停止。骨折复位后，患者出现持续性鼻咽部出血。怀疑有颅内血管损伤，我们进行了血管造影。血管造影显示蝶腭动脉假性动脉瘤。进行了血管内栓塞治疗，两名患者均成功止血。由于靠近翼突板，涉及翼突板的颧上颌复合体骨折可能会导致蝶腭动脉损伤。蝶腭动脉损伤的唯一表现是常见的鼻咽部出血。根据我们的临床经验，尽管颌面外伤后上颌动脉分支假性动脉瘤的发生率较低，但对于怀疑涉及深部动脉的损伤，建议早期通过血管造影进行影像学检查，以处理面部外伤或手术后的反复出血。
