Retrograde Hemorrhage (Hemolacria) From the Lacrimal Puncta After a Le Fort I Osteotomy: A Report of 2 Cases and a Review of the Literature

Humber, Craig C.; Lanigan, Dennis T.; Hohn, F.I.

doi:10.1016/j.joms.2009.12.031

Cited by 20 publications

(18 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…16 Posterior vessels are larger in caliber than the distal arteries and capillaries of the anterior nasal cavity, and are more likely to cause extensive and persistent bleeding when damaged. 27 Excessive intraoperative bleeding (n = 10), particularly following maxillary down-fracture or palatal expansion, indicates large vessel injury that may rebleed postoperatively. 20 Similarly, thickened or scarred bone may require that excess force be used during surgery, predisposing to vessel injury.…”

Section: Resultsmentioning

confidence: 99%

Epistaxis After Orthognathic Surgery: Literature Review and Three Case Studies

Girard

Lopez

Chen

et al. 2021

Craniomaxillofacial Trauma & Reconstruction

View full text Add to dashboard Cite

Study Design: This is a literature review with 3 case studies. Objective: Intraoperative and postoperative bleeding are the most common complications of orthognathic surgery and have the potential to become life-threatening. The rarity of severe postoperative epistaxis has resulted in limited characterization of these cases in the literature. The purpose of this study is to 1) differentiate various presentations of epistaxis following orthognathic surgery in the literature, 2) identify management approaches, and 3) to synthesize a treatment algorithm to guide future management of postoperative epistaxis. Methods: A literature search of PubMed was conducted and 28 cases from 17 studies were assessed. Results: Bleeding within the first week may indicate isolated epistaxis, often resolved with local tamponade. Half of cases were attributed to pseudoaneurysm rupture (n = 14), with epistaxis onset ranging from postoperative day 6 to week 9. Angiography was used in most cases (n = 17), often as the primary imaging modality (n = 11). Nasal endoscopy is a less invasive and effective alternative to angiography with embolization. Proximal vessel ligation was used in 3 cases but is not preferred because collaterals may reconstitute flow through the defect and cause rebleeding. Repeat maxillary down-fracture with surgical exploration was described in 4 cases. Conclusions: As outlined in our management algorithm, nasal packing and tamponade should be followed by either local electrocautery or vascular imaging. Angiography with embolization is the preferred approach to diagnosis and management, whereas surgical intervention is reserved for cases of embolization failure or unavailability.

show abstract

Section: Resultsmentioning

confidence: 99%

Epistaxis After Orthognathic Surgery: Literature Review and Three Case Studies

Girard

Lopez

Chen

et al. 2021

Craniomaxillofacial Trauma & Reconstruction

View full text Add to dashboard Cite

show abstract

“…The development of a nasopalatine duct cyst, bilateral lingual anesthesia and orbital compartment syndrome, have also been reported among some unusual complications (2). There are also publications that mention complications related to expansion device (21).…”

Section: Discussionmentioning

confidence: 98%

Evaluation of Complications Associated with Surgically Assisted Rapid Maxillary Expansion in Cases with or Without Pterygomaxillary Disjunction

Gürsoytrak¹,

Ünüvar²,

Albayrak³

2021

meandros

View full text Add to dashboard Cite

Objective: Surgically assisted rapid maxillary expansion (SARME) is a widely used treatment method for the correction of transversal deficiencies of the maxilla. The gold standard treatment method among various surgical techniques has not been established. This retrospective study aimed to determine complications in SARME cases with and without pterygomaxillary disjunction and evaluate the differences between intraoperative and post-operative complications between the two groups. Materials and Methods: We enrolled 38 patients (25 females and 13 males) who underwent SARME under general anaesthesia at Aydın Adnan Menderes University Faculty of Dentistry between January 2015 and January 2020 in this study. These patients were divided into the following two groups: Patients with pterygomaxillary disjunction group and patients without pterygomaxillary disjunction group. The intraoperative and post-operative complications were evaluated for both the groups. Results: Technically, the pterygoid junction was broken in 17 of the 38 patients included in this study with SARME; however, it was intact in 21 patients. Intraoperative haemorrhage was observed in two patients in the group with pterygomaxillary disjunction and in one patient in the group without pterygomaxillary disjunction. Electrocauterisation was performed to control bleeding in both the groups. In the group with pterygomaxillary disjunction, postoperative hematoma was observed following intraoperative haemorrhage in two patients, post-operative asymmetric expansion in two patients and post-operative unilateral transient paraesthesia in one patient. Conclusion:The most common complication was haemorrhage, which was more observed in the group with pterygomaxillary disjunction. However, asymmetric disjunction was also seen in the group with pterygomaxillary disjunction. Whereas, minor complications were observed in the group without pterygomaxillary disjunction. As a result, the surgical technique, where the pterygoid junction remained intact, has minimal risk for complications.

show abstract

“…In the setting of epistaxis with tamponade, blood pools in the inferior turbinate of the nasal fossae. From this area it can ascend through the Valve of Hasner into the nasolacrimal duct and lacrimal sac, pass through the valve of Rosenmüller, and then extrude through the lacrimal canaliculi and enter the eye as bloody tears via the lacrimal puncta 5 (see Figure 1). If the source of the epistaxis is distal to the Valve of Hasner, a significant arterial hemorrhage is likely, and nasal tamponade may theoretically cause the valve to become incompetent and result in a retrograde nasolacrimal hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

“…If the source of the epistaxis is distal to the Valve of Hasner, a significant arterial hemorrhage is likely, and nasal tamponade may theoretically cause the valve to become incompetent and result in a retrograde nasolacrimal hemorrhage. 5 Hemolacria, however, is rare; it does not occur in most patients with epistaxis, even those with severe arterial hemorrhage treated with nasal tamponade. This raises the question of whether there is a rare anatomic anomaly that might increase the risk for hemolacria.…”

Section: Discussionmentioning

confidence: 99%

“…H emolacria, or "bloody tears," is a rare clinical condition that has been described primarily in case reports. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] According to a comprehensive historical review of hemolacria by Murube, 2 the first mention of bloody tears in the medical literature was in the sixth century AD, and numerous cases have been reported since the beginning of the nineteenth century.…”

mentioning

confidence: 99%

See 1 more Smart Citation