顎骨骨折に併発した外傷性頸動脈海綿静脈洞瘻の１例

• Published in: 日本口腔外科学会雑誌 Vol. 70; no. 12; pp. 520 - 525
• Main Authors: 福田, 修平, 原田, 浩之, 吉住, 結, 生田, 稔
• Format: Journal Article
• Language: Japanese
• Published: 公益社団法人 日本口腔外科学会 20.12.2024
• Subjects: コイル塞栓; 外傷性頸動脈海綿静脈洞瘻; 脳血管造影
• ISSN: 0021-5163; 2186-1579
• DOI: 10.5794/jjoms.70.520

Traumatic carotid-cavernous sinus fistula (CCF) is a rare disorder in which the internal carotid artery is injured by trauma, forming an arteriovenous fistula in the cavernous sinus. We report a case of traumatic CCF associated with jaw fractures. A 37-year-old male patient was referred to our emergency room in November 2022 due to injuries sustained in a traffic accident. He was conscious with JCS 10, and left-sided eye protrusion and mandibular dislocation were observed. CT revealed a left-sided maxillary fracture, mandibular fractures, and dilatation of the left-sided superior ophthalmic vein. A cerebral angiography was performed on the 6th day of admission, and a definitive diagnosis of traumatic CCF was made. On the 8th day of admission, the patient underwent open reduction and fixation of the mandibular fracture, and on the 12th day of admission, a coil embolization and parent artery occlusion (internal trapping) were performed in the neurosurgery department. No postoperative recurrence has been observed at 18 months after the surgery. Even in cases comprising jaw fracture only, strict follow-up is necessary while keeping in mind the possibility of traumatic CCF developing.