Left Maxillary Artery Research Articles

Sino nasal undifferentiated carcinoma – A diagnostic conundrm

Sinonasal undifferentiated carcinoma (SNUC) is a rare and highly aggressive tumour frequently arising from the maxillary sinus and nasal cavity. Here we report a 34-year-old female patient who presented with a pale polypoidal mass which bleeds on touch involving the left nasal cavity and nasopharynx. Imaging showed a multilobulated lesion involving the left nasal cavity and left paranasal sinuses with extension into the left masticator space, pterygopalatine fossa and retropharyngeal space supplied by a branch of the left maxillary artery. It suggested a possibility of a benign vascular mass lesion. The mass was surgically removed via the maxillary swing approach. Immunohistochemical analysis showed epithelial origin (AE1/AE3+, EMA+) and no reactivity for neuroendocrine, melanocytic, hematolymphoid, or mesenchymal markers. A diagnosis of SNUC was reached and the patient was given concurrent radiotherapy and chemotherapy. The patient is disease free one year post surgery. To conclude, a vigilant correlation of clinical, microscopic, and immunohistochemical characteristics is essential for early diagnosis and optimal management of SNUC.

The Maxillary Artery Loops Dangerously Approaching the Mandible's Lingula and Inferior Orbital Fissure.

The maxillary artery (MA) leaves from the external carotid artery and further courses through the infratemporal fossa to reach the pterygopalatine fossa. It typically has an ascending course either on the lateral or on the medial side of the inferior bundle of the lateral pterygoid muscle. While studying retrospectively, the computed tomography angiogram of an adult male case with peculiar tortuosities of the MA was documented. The left MA described a large inferior sagittal loop applied on the mandible's ramus's inner cortical in the pterygomandibular space's upper part. That loop reached 1.66 cm inferior to the mandible's notch and 0.5 cm superior to the mandibular foramen and was applied on the mandible's lingula (spine of Spix). That MA continued to the pterygomaxillary suture, and a second superior coronal loop was found applied on the posterior wall of the maxillary sinus, reaching the inferior orbital fissure. It is therefore mandatory to take good care in the decortication of the mandibular ramus or during osteotomies of the ramus. When an inferior loop of the MA approaches the spine of Spix, bleeding when an inferior alveolar nerve block is performed seems hardly avoidable.

Maxillary Artery runs medial to the mandibular nerve unilaterally: Case report and Literature Review

Background: The maxillary artery supplies the deep structures of the face and cranium. The maxillary artery and the mandibular nerve form a clinically important relation in the infratemporal fossa. Variations of the maxillary artery may complicate dental, oral, and maxillofacial surgeries in this region. Methods: During routine academic dissection of a 91-year-old Caucasian female cadaver, the pterygoid segment of the left maxillary artery was found medial to the posterior division of the mandibular nerve in the infratemporal fossa. Results: The maxillary artery coursed superior to the point of division of the mandibular nerve and remained undivided. Conclusion: This rare unilateral variation will be of interest to anatomists and clinicians, as an understanding of anatomical variations of the maxillary artery can help decrease the risk of hemorrhage and other surgical complications. KEY WORDS: Maxillary artery, Mandibular nerve, Lateral pterygoid muscle, Infratemporal Fossa.

Uncontrolled Epistaxis Secondary to Traumatic Pseudoaneurysm of the Maxillary Artery

We describe a rare case of traumatic pseudoaneurysm of the maxillary artery following a fall. The patient presented with epistaxis that could not be controlled with anterior and posterior nasal packing. She was urgently taken to the angiography suite for evaluation and ultimately underwent embolization of a left maxillary artery pseudoaneurysm with 500–700 micron Contour PVA followed by coiling with two 3 mm Tornado coils. Bleeding subsided after embolization, and the patient suffered no neurologic sequelae.

Fístula arteriovenosa postraumática: tratamiento endovascular. Revisión de la literatura y presentación de un caso clínico

Traumatic arteriovenous fistulas of the head and neck region are uncommon. The majority are due to penetration of blunt injury. We describe a successful endovascular treatment of a posttraumatic fistula between the left maxillary artery and the external jugular vein due to a penetration injury. This case and a review of the literature illustrate the causes, manifestations, image studies and treatment for a posttraumatic fistula between the maxillary artery and the external jugular vein. This case demonstrate the utility of endovascular treatment of head and neck injuries complications.

Maxillary Sinus Haemangioma: an Unusual Cause of Postextraction Haemorrhage

Haemangoms of the maxillary sinus are very rare. We report the case of a 22-year-old Chinese lean who presented with intermittent profuse bleeding and progressive swelling of the left cheek following upper left molar extraction. A haemangioma was suspected. Computed tomography scanning showed a large, heterogeneous, enhancing mass with a defect in the floor of the maxillary sinus. Preoperative angiography and embolisation revealed that the left maxillary artery was the predominant blood supply. The entire tumour was removed successfully. Histopathological examination confirmed the diagnosis of haemangioma.

下顎骨に転移した胸壁原発悪性血管内皮腫の１例

A case of mandibular metastasis from malignant hemangioendothelioma of the chest wall is reported.On October 5, 2000, a 65-year-old man, who had been admitted for malignant hemangioendothelioma of the chest wall, came to our department for bleeding after extraction of the lower left second molar. The bleeding was associated with granulation-like tissue in the extraction fossa. Panoramic radiography showed osteolytic lesions in the left body of the mandible and both heads of the mandible. Bleeding was stopped by vascular embolization of the left maxillary artery. Biopsy was performed, and histological examination revealed mandibular metastasis of a malignant hemangioendothelioma of the chest wall. The patient later underwent radiotherapy because of severe pain. Although the mandibular tumor grew, bleeding and pain were controlled, and his quality of life improved. He died of respiratory failure 1 month after our first medical examination.

上顎洞にみられた顎動脈外傷性動脈りゅう

A case of traumatic aneurysm was reported. A 25-year-old man was admitted to our hospital with severe epistaxis and oral hemorrhage caused by a fall. Multiple maxillofacial fractures were found by CT. Nasal packing for the epistaxis and reduction of the fractured mandible were immediately performed. The patient seemed to be doing well; however, epistaxis reoccured 13 days after the injury. Nasal packing was not effective for the recurrent bleeding.To confirm the bleeding site, angiography by the Seldinger technique was performed. Angiography demonstrated the presence of an aneurysm in the area of the left maxillary artery. Therefore, superselective embolization using microcoils was performed. After this procedure, epistaxis was completely controlled.