Gotoh Shuho, Osanai Toshiya, Ushikoshi Satoshi, Kurisu Kota, Shimoda Yusuke, Houkin Kiyohiro
Department of Neurosurgery, Hokkaido University Graduate School of Medicine.
No Shinkei Geka. 2020 Apr;48(4):335-340. doi: 10.11477/mf.1436204187.
Le Fort I osteotomy, one of the most common techniques applied to correct jaw deformities, is generally considered operatively safe. However, a few articles reported that this procedure can lead to formation of arteriovenous fistulae(AVF)involving the maxillary artery infrequently.
A man in his 40s with a jaw deformity underwent Le Fort I osteotomy. Two days later, he noticed pulsating tinnitus in his right ear. Angiography revealed AVF between the proximal part of the maxillary artery(first segment)and the pterygoid plexus. On further evaluation, AVF were embolized with n-butyl-2-cyanoacrylate(NBCA). Obliteration of AVF was confirmed on the final angiography. The tinnitus resolved shortly after the embolization.
Embolization with NBCA is a promising treatment for maxillary AVF after Le Fort I osteotomy.
勒福Ⅰ型截骨术是矫正颌骨畸形最常用的技术之一，一般认为手术安全。然而，有几篇文章报道，该手术偶尔会导致涉及上颌动脉的动静脉瘘（AVF）形成。
一名40多岁的颌骨畸形男性接受了勒福Ⅰ型截骨术。两天后，他注意到右耳有搏动性耳鸣。血管造影显示上颌动脉近端（第一段）与翼静脉丛之间存在动静脉瘘。进一步评估后，用正丁基-2-氰基丙烯酸酯（NBCA）栓塞动静脉瘘。最终血管造影证实动静脉瘘闭塞。栓塞后耳鸣很快消失。
NBCA栓塞术是治疗勒福Ⅰ型截骨术后上颌动静脉瘘的一种有前景的治疗方法。
