Pseudoaneurysms and Orthognathic Surgery: A Systematic Review and a Proposed Algorithm of Treatment

AlQahtani, Feras AlMofreh; Kuriadom, Sam Thomas; Bishawi, Khaled; AlAssiri, Nasser

doi:10.1097/scs.0000000000009134

Cited by 3 publications

(2 citation statements)

References 46 publications

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“…Pseudoaneurysms have been reported to occur less frequently in mandibular osteotomies than in maxillary osteotomies (13,14). The first report of a pseudoaneurysm in a mandibular osteotomy was by Clark et al (15) in 1987 who reported a pseudoaneurysm following a mandibular vertical branch osteotomy.…”

Section: Discussionmentioning

confidence: 99%

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Pseudoaneurysm of the superficial temporal artery after sagittal split ramus osteotomy: A case report

Kato,

Yoshida,

Onishi

et al. 2023

Exp Ther Med

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Sagittal split ramus osteotomy (SSRO) is a widely performed orthognathic surgery; however, among the various reported complications of SSRO, pseudoaneurysms are rarely reported. Pseudoaneurysms are rare vascular lesions formed by damage to the arterial wall that can occur after trauma or postoperatively, causing uncontrolled bleeding. The present report describes a case of a pseudoaneurysm that occurred after SSRO in a 22-year-old female patient. Le Fort I osteotomy and bilateral SSRO were performed under general anesthesia to improve the gummy smile and mandibular asymmetry of the patient. While osteotomizing the medial side of the left SSRO, major bleeding occurred from the soft tissue of the posterior margin of the mandibular branch. Direct compression with gauze and a local hemostatic agent stopped the bleeding. Immediately after returning to the ward, bleeding was observed from the left wound site and marked swelling of the left buccal area occurred. Contrast-enhanced computed tomography revealed a pseudoaneurysm of the left superficial temporal artery (STA). Subsequently, arterial embolization for the pseudoaneurysm was performed. Overall, the present report describes a rare case of pseudoaneurysm of the STA as a postoperative complication of SSRO.

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Section: Discussionmentioning

confidence: 99%

“…AlQahtani et al (14) reported that CT angiography should be performed, and intervention should be indicated in the presence of epistaxis, significant facial edema, and pain after Le Fort I osteotomy. In our case, a pseudoaneurysm of the left STA was diagnosed using CT angiography after sudden hemorrhage and swelling.…”

Section: Discussionmentioning

confidence: 99%

Pseudoaneurysm of the superficial temporal artery after sagittal split ramus osteotomy: A case report

Kato,

Yoshida,

Onishi

et al. 2023

Exp Ther Med

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Management of two postoperative pseudoaneurysms after Le Fort I osteotomy

Moafi,

Al-Adili,

Ahlén Swartling

et al. 2024

Oral and Maxillofacial Surgery Cases

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Delayed Hemorrhage From a Pseudoaneurysm of the Inferior Alveolar Artery following Maxillomandibular Advancement: A Case Report

Tran,

Will,

Salcines

et al. 2024

FACE

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Maxillomandibular advancement is a common orthognathic surgical procedure in the treatment of obstructive sleep apnea. Although rare, pseudoaneurysms may form following orthognathic surgery, which includes maxillomandibular advancement. Iatrogenic pseudoaneurysms from orthognathic surgery typically occur in the branches of the maxillary artery (sphenopalatine and descending palatine branches) or the facial artery, but uncommonly affect the inferior alveolar artery. We present a unique case of a pseudoaneurysm hemorrhage of the inferior alveolar artery on postoperative day 10 following maxillomandibular advancement diagnosed by computed tomographic angiography and successfully treated with fluoroscopy-guided endovascular embolization. Pseudoaneurysm hemorrhages of the inferior alveolar artery following orthognathic surgery are rare, with only 1 known published case report which occurred with significant intraoperative pulsatile bleeding. This is the only known case of a delayed inferior alveolar artery pseudoaneurysm bleed in the absence of significant intraoperative hemorrhage.

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Pseudoaneurysms and Orthognathic Surgery: A Systematic Review and a Proposed Algorithm of Treatment

Cited by 3 publications

References 46 publications

Pseudoaneurysm of the superficial temporal artery after sagittal split ramus osteotomy: A case report

Pseudoaneurysm of the superficial temporal artery after sagittal split ramus osteotomy: A case report

Management of two postoperative pseudoaneurysms after Le Fort I osteotomy

Delayed Hemorrhage From a Pseudoaneurysm of the Inferior Alveolar Artery following Maxillomandibular Advancement: A Case Report

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