Life-Threatening Bleeding of Bilateral Maxillary Arteries in Maxillofacial Trauma: Report of Two Cases

Management of Maxillofacial Injuries With Severe Oronasal Hemorrhage: A Multicenter Perspective

“…The efficacy of packing techniques alone or with temporary fracture reduction has been questioned by other investigators. 6,8,9 Failure of packing in patients with severe maxillofacial trauma may be caused by combined nasal and oral bleeding with large defects allowing communication between the nasal and oral cavities. 6,9 In patients with comminuted facial fractures, there may be insufficient solid bony walls for packing to buttress against.…”

“…6,8,9 Failure of packing in patients with severe maxillofacial trauma may be caused by combined nasal and oral bleeding with large defects allowing communication between the nasal and oral cavities. 6,9 In patients with comminuted facial fractures, there may be insufficient solid bony walls for packing to buttress against. 6,9 Packing is also ineffective for bleeding from ethmoid arteries and distal branches of the internal maxillary artery, such as the sphenopalatine and descending palatine arteries.…”

Proximal external carotid artery embolization as a damage control resuscitation technique for combined severe traumatic brain injury with uncontrolled oronasal haemorrhage and severe pelvic fracture in haemorrhagic shock

“…6 Several studies suggested the effective of proximal embolization for solid organ injury and pelvic injuries with less frequent and smaller infarcts than selective embolization and this procedure enabled effective haemostasis within a limited time. 2,3,9 When marked oronasal haemorrhage with haemorrhagic shock combining TBI, especially EDH and/or subdural haemorrhage, are determined, angiography is effective to identify haemorrhaging artery. If vascular injury which was suspected to be a cause of intracranial haemorrhage was detected on angiography with uncontrolled oronasal haemorrhage, we strongly suggest that proximal ECA embolization is one of the treatment options as a damage control resuscitation technique to obtain adequate haemostasis of both marked oronasal haemorrhage and TBI with life-threatening trauma and to prevent metabolic failure by a major reduction of blood loss.…”

An extensive retropharyngeal haematoma associated with pyramidal fracture: A case report

“…7 If pressure packing and haemostatic agents do not effectively control bleeding, ECA ligation or transcatheter arterial embolization (TAE) may be employed. 2,5,7 We report herein a case of maxillary artery injury with a rare underlying mechanism. We believe that this type of injury may present diagnostic challenges for physicians in emergency settings.…”

“…5 Oronasal bleeding is a common physical finding following injury to the maxillary artery and its branches. 2 Maxillary artery injury can result in uncontrollable bleeding because it branches from the external carotid artery (ECA), an easily damaged artery following facial trauma. 7 If pressure packing and haemostatic agents do not effectively control bleeding, ECA ligation or transcatheter arterial embolization (TAE) may be employed.…”