Airway Management and Control of Severe Hemorrhage by Transarterial Embolization Through Interventional Radiology and 3-Staged Repair of Multiple Facial Fractures in a Maxillofacial Trauma Patient

Abstract

Airway compromise and severe hemorrhage are the two most common life-threatening problems associated with maxillofacial trauma. The treatment of intractable hemorrhage to prevent airway obstruction and hypovolemic shock is imperative. Common methods for initially controlling hemorrhage include oronasal packing, placement of Foley catheters, and temporary reduction of facial fractures. When these measures are unsuccessful, carotid artery ligation has proven effective. However, the modern application of Interventional Radiology to achieve trans-arterial embolization (TAE) of the offending vessel is equally effective and offers improved morbidity and mortality. Here we present a case of a 39-year-old male who sustained life threatening hemorrhage of bilateral internal maxillary artery with multiple facial fractures. The purpose of this report is to discuss evidence based approach to control and treat intractable hemorrhage in complex maxillofacial trauma patients.