Hemorrhagic complications of facial fractures

Abstract

Two hundred ninety‐six facial fracture patients, exclusive of nasal fracture patients treated on an out‐patient basis, came to the Medical College of Virginia Hospitals between January 1, 1970, and December 31, 1972. The various managing services, age and sex of the patients, and the months of occurrences were tabulated. Of interest were six patients who had a hemorrhagic complication after adequate surgical reduction — about a 2 percent incidence. All six patients sustained fractures of the fronto‐naso‐ethmoid complex, medial wall of the maxillary sinus and middle turbinate region. Five patients required transantral ligation of the sphenopalatine branch of the internal maxillary artery and one patient required an anterior ethmoidal artery ligation. All bleeding ceased after surgical ligation of the bleeding vessel. A typical patient was presented and the increased morbidity and prolonged hospital stay reviewed before the proper surgical ligation was performed. The authors stress the importance of careful evaluation of all facial fractures, proper identification of exactly what bones are fractured, and the prompt therapy.

Initial Management of Massive Oral Bleeding after Midfacial Fracture

“…3,4 According to the literature, the incidence of mas- sive bleeding in maxillofacial trauma tends to increase in complex fractures associated with midface fractures. [5][6][7][8][9][10][11] The present study also found a significant correlation between Le Fort fractures and massive bleeding in the maxillofacial region (9.61%). Furthermore, we found that the most frequent source of massive bleeding in midfacial fractures was the nose, which bled through the oral cavity.…”

“…In fact, death from such injuries has been reported. 5,6 Frable et al 7 found that among 296 patients with midfacial fractures, 9.4% developed severe bleeding. Among 312 facial fractures reviewed by Buchanan and Holtmann, 8 12 (11%) of 108 had midfacial fractures.…”

“…[2][3][4][5][6][7][8][9][10][11] Little has been published about bleeding after midfacial fracture. 5,8,10 Thus, sources of massive bleeding and treatment strategies have not been adequately assessed.…”

BALLOON COMPRESSION OF THE INTRAMAXILLARY SINUS FOR INTRACTABLE POST-TRAUMATIC BLEEDING FROM THE MAXILLARY ARTERY: Case report

“…It is a rare complication of midfacial fractures with a reported incidence of 9.4% (2). It can cause life-threatening blood loss.…”

Prognostic Factors of Survival From Intractable Oronasal Bleeding After Successful Transarterial Embolization

“…[1][2][3][4] In patients with massive bleeding refractory to conventional therapy, such as manual pressure and nasal packing, the compromised airway and profound shock status often are the major cause of mortality. Percutaneous endovascular treatments, such as transarterial embolization (TAE), have emerged as the rescue choice for intractable nasal bleeding since their successful introduction to intractable epistaxis in emergency or elective cases.…”