Carotico-cavernous fistula following septorhinoplasty

Pothula, Vijay; Reddy, K. T. V.; Nixon, T.

doi:10.1017/s0022215100145360

Cited by 8 publications

(7 citation statements)

References 18 publications

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“…Apart from presenting signs and symptoms, the only relevant clinical test confirming the diagnosis of CCF is that bruit must cease with digital compression of the ipsilateral carotid artery in the neck. 18 In our case, since the bruit over the right supra-orbital region was feeble, it did not comply with the digital compression test. The current gold standard in the diagnosis of CCF is the digital subtraction cerebral angiography that was also performed in our case.…”

Section: Diagnosis and Treatmentmentioning

confidence: 63%

“…12 The trauma may be direct, such as orbital penetration, or indirect, like impingement by a bony spicule or from a middle cranial fossa fracture resulting in a tear in the wall of ICA. Iatrogenic causes are multiple, including Le Fort I osteotomy, [13][14][15] maxillectomy, 16 orbital floor fracture repair, 17 septorhinoplasty, 18,19 and spheno-ethmoidal surgery. 20 Carotid cavernous fistulas have been classified as per their hemodynamic properties, etiology, or anatomy of the fistula (as shown in Supplemental Table 1, Supplemental Digital Content 1, http://links.lww.com/SCS/F812).…”

Section: Incidence and Classification Of Ccfmentioning

confidence: 99%

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Carotid Cavernous Fistula as a Rare and Late Complication of Maxillofacial Injury: A Brief Clinical Study

Yadav,

Hosur,

Rangan

et al. 2024

Journal of Craniofacial Surgery

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Carotid- Cavernous Fistula (CCF) represents an aberrant vascular communication at the skull base between the high-flow carotid arterial system and the low-flow venous channels within the cavernous sinuses of the sphenoid bone. Benjamin Travers, in the year 1809, described this condition as “pulsating exophthalmos”. This case is a presentation of a carotid cavernous fistula in an operated case of maxillofacial injury as a late complication. The individual presented with a nonresolving proptosis and chemosis for the past 9 weeks. This presentation enumerates how the diagnosis was made, though being a rare complication and how it was promptly managed that resulted in a remarkable resolution of signs and symptoms.

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Section: Diagnosis and Treatmentmentioning

confidence: 63%

Section: Incidence and Classification Of Ccfmentioning

confidence: 99%

Carotid Cavernous Fistula as a Rare and Late Complication of Maxillofacial Injury: A Brief Clinical Study

Yadav,

Hosur,

Rangan

et al. 2024

Journal of Craniofacial Surgery

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“…Traumatic pseudoaneurysms presenting with recurrent epistaxis are even rarer, from 1928 when Birley and Trotter first reported such a case to 1990, only about 100 cases have been reported in the world literature 3,14 . Traumatic CCF concomitant with pseudoaneurysm in the sphenoid sinus presenting with epistaxis is an extremely rare occurrence with few reports in the literature 4,15,21,18,19 . It is well known that the ICA is divided into four portions: cervical, petrous, cavernous and cerebral.…”

Section: Discussionmentioning

confidence: 99%

Traumatic Carotid Cavernous Fistula Concomitant with Pseudoaneurysm in the Sphenoid Sinus

Huai

et al. 2008

Interv Neuroradiol

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This study was designed to elucidate the generating mechanism, diagnosis and treatment of traumatic carotid cavernous fistula (tCCF) concomitant with pseudoaneurysm in the sphenoid sinus. Six cases of tCCF concomitant with pseudoaneurysm in the sphenoid sinus were analyzed in this study. Clinical history, neurological examination, CT and MRI scans, pre- and postembolization cerebral angiograms and follow-up data were included. All patients presented with massive epistaxis and symptoms of tCCF. The pseudoaneurysms and fistulas were occluded with detachable balloons, and preservation of the parent artery in two cases. One patient also had indirect carotid cavernous fistula (CCF) on the contralateral side embolized by transfacial vein approach with microcoils. Complete symptom resolution was achieved in all cases, without procedure related complications. During the follow-up period all patients returned to work. Falling from a high speed motorcycle without wearing a helmet may be one of the main causes of this disease. The site of impact during the accident mostly localizes in the frontal and lateral of the orbit. Intracavernous sinus hypertension of tCCF combining with fracture of the lateral wall of the sphenoid may lead to the formation of a pseudoaneurysm in the sphenoid sinus. MRI scan is very helpful in the diagnosis of this disease before the patient receives angiography. Detachable balloon occlusion of the pseudoaneurysm and fistula is a safe and efficient treatment.

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“…dilated forehead veins, headache and raised intra-orbital pressure). Patients may also develop pulsatile proptosis and visual disturbances 38 , 39 …”

Section: Carotid–cavernous Fistulamentioning

confidence: 99%