Traumatic facial artery aneurysm: case report

Huge true aneurysm of the facial artery treated with internal trapping and surgical excision: a case report

A report of true aneurysms is extremely rare. There are only five previous case reports of true aneurysm of the facial artery. In the previously reported cases, there was no case that underwent trapping and surgical excision. In this case report, we describe the procedure of internal trapping before the surgical excision of a huge true aneurysm of the right facial artery for a 79-year-old woman. There was no recurrence of the aneurysm during a 6-month follow-up period.

Pseudoaneurysm of the facial artery occurred after mandibular sagittal split ramus osteotomy

Introduction

Pseudoaneurysms are caused by rupture of arteries with extravasation of blood. The compressed perivascular tissue forms the wall of aneurysmal sac. Pseudoaneurysm directly related with surgical procedure of sagittal split ramus osteotomy (SSRO) was reported quite rarely especially related with facial artery during the vertical osteotomy.

Case report

SSRO was carried out for a 19-year-old male; the patient visited the emergency room with notable swelling 3 weeks after the surgery. We experienced severe intra-oral bleeding with surgical exploration. Angiography revealed a pseudoaneurysm of the right facial artery that might be related with vertical osteotomy over lateral cortex of the mandibular body during orthognathic surgery. This implies that the minor vascular trauma from vertical osteotomy of the mandibular body during the conventional orthognathic surgery might cause later development of pseudoaneurysm.

Traumatic pseudoaneurysm of the facial artery: late complication and effects on local blood flow

OBJECTIVE

Pseudoaneurysms are vascular injuries resulting from a rupture of the vessel walls with blood extravasation into perivascular tissues. Proper treatment is required to prevent rupture and intense bleeding. This article reports a case of pseudoaneurysm of the facial artery that evolved to a late complication, presenting dehiscence of suture and exposure of the wound and bleeding after the initial injury and also discusses the effects of vascular response from the involved vessels by comparing them against the contralateral side.

CASE REPORT

A healthy 17-year-old male was admitted with an injury of approximately 35 mm in length in the right cheek with an exposed clot inside the injury and local bleeding after a stabbing 11 days before. CT angiography showed rupture of the facial artery and formation of a pseudoaneurysm with an organized clot. The patient was treated by means of surgery under local anesthesia and intravenous sedation. The facial artery was located and attached by suture. The wound was explored and clots were removed. The patient was discharged on the first postoperative day and he had an excellent scarring standard with no unfavorable event.

CONCLUSIONS

The authors conclude that this surgical technique is an effective method for treating such injuries, as it is easily performed and can be conducted by the oral and maxillofacial surgeon assistant.

True aneurysm of the facial artery

True aneurysm of the facial artery is extremely rare. We describe a case of true facial aneurysm of the submandibular lesion in a 73-years-old man. A color Doppler ultrasonography and computed tomography (CT) revealed a 2.1 cm x 1.5 cm aneurysm with turbulent arterial flow and some thrombus inside the lumen. At the operation, the aneurysm was excised and proximal and distal ends of the facial artery were ligated. The histopathologic examination confirmed a true aneurysm of the facial artery with degenerative changes of the wall and some thrombus in the lumen. The postoperative course was uneventful, and no recurrence has been noted in more than 1-year follow-up.

True atherosclerotic aneurysm of the facial artery

True aneurysms of the facial artery are rare. This is the case report of a diabetic, hypertensive patient with a true aneurysm of the facial artery.