A noisy zygoma fracture—complication of carotid-cavernous sinus fistula: total recovery of monocular blindness and frozen-eye after endoarterial coil embolization

• Published in: International journal of oral and maxillofacial surgery Vol. 34; no. 2; pp. 214 - 219
• Main Authors: Bierenbroodspot, F., Van Damme, Ph.A., Cruysberg, J.R.M.
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 01.03.2005; Elsevier
• Subjects: Accidental Falls; Aged; Bicycling - injuries; Biological and medical sciences; blindness; Blindness - etiology; Blindness - therapy; carotid-cavernous sinus fistula; Carotid-Cavernous Sinus Fistula - etiology; Carotid-Cavernous Sinus Fistula - therapy; cavernous sinus; complication; Dentistry; Embolization, Therapeutic - instrumentation; Embolization, Therapeutic - methods; Follow-Up Studies; frozen-eye; Humans; Injuries of the limb. Injuries of the spine; Joint Dislocations - complications; Male; Medical sciences; murmur/sound/noise/rumour; oculomotility; Ophthalmology; Ophthalmoplegia - etiology; Ophthalmoplegia - therapy; orbital apex syndrome; Orbital Fractures - complications; Otorhinolaryngology. Stomatology; Recovery of Function; Traumas. Diseases due to physical agents; Vision disorders; Vision, Monocular; zygoma fracture; Zygomatic Fractures - complications; murmur/sound/noise/rumour; frozen-eye; complication; cavernous sinus; zygoma fracture; blindness; orbital apex syndrome; carotid-cavernous sinus fistula; oculomotility; Human; Cavernous sinus; Malar bone; Stomatology; Vision disorder; Diseases of the osteoarticular system; Instrumentation therapy; Fistula; Fracture; Trauma; Case study; Eye disease; Surgery; Zygomatic arch; Blindness; Complication; Embolization
• ISSN: 0901-5027; 1399-0020
• DOI: 10.1016/j.ijom.2004.03.017

A case of a patient with a zygoma fracture in combination with a carotid-cavernous sinus fistula—an arterio-venous fistula between the internal carotid artery and the cavernous sinus—is presented. The most frequent cause is trauma, but the carotid-cavernous sinus fistula itself may have been the cause of trauma. The patient showed complete loss of ocular motility and total monocular blindness. Treatment of the fistula with endoarterial coil embolization was followed by improvement of vision and ocular motility, until finally complete recovery of ocular functions, which is exceptional. In this case, careful analysis of the MRA's showed that the CCSF most likely developed in the posttraumatic phase.