Case 24
Simon Lloyd, Manohar Bance, Jayesh Doshi in ENT Medicine and Surgery, 2018
This chapter describes a clinical case scenario of a 40-year-old male patient who has been having recurrent tonsillitis for the last few years. It includes thought-provoking questions followed by reasoned answers and is superbly illustrated with diagrams and high quality photographs. The questions include: What are the common indications for tonsillectomy? What are the risks of tonsillectomy? What is the blood supply to the tonsil? The inferior pole is supplied by the tonsillar branch of the dorsal lingual artery, the tonsillar branch of the facial artery and the ascending palatine artery. The superior pole is supplied by the tonsillar branch of the ascending pharyngeal artery and the lesser palatine artery. This will be an invaluable text for otorhinolaryngologists in practice and in training, from hospital-based surgeons preparing for higher examinations to established physicians for their continuing professional development.
Facial neurovascular supply, salivary glands
Ian Parkin, Bari Logan, Mark McCarthy in Core Anatomy - Illustrated, 2007
The facial artery (12), branch of external carotid, is palpable as it passes over the mandible, anterior to masseter (13). The left and right facial arteries anastomose freely. Veins converge on the facial vein (14), which joins the internal jugular. There may be deep connections to the cavernous sinus via the venous plexus around the pterygoid muscles (route for spread of infection).
Recurrent post-tonsillectomy bleeding due to an iatrogenic facial artery pseudoaneurysm
Published in Acta Oto-Laryngologica Case Reports, 2017
Kevin J. Choi, Tracy Cheng, Mary I. H. Cobb, Mirabelle B. Sajisevi, L. Fernando Gonzalez, Marisa A. Ryan
This is a report of an illustrative case of recurrent post-tonsillectomy bleeding that was caused by an iatrogenic facial artery pseudoaneurysm and controlled by endovascular embolization. A 37 year-old female who underwent bilateral tonsillectomy for chronic tonsillitis had recurrent secondary hemorrhage despite multiple operative interventions to control the bleeding. Because of the recurrent nature of the bleeding, an angiography of the external carotid artery was performed demonstrating a pseudoaneurysm of the left facial artery with active extravasation. This was successfully embolized with ethylene vinyl alcohol copolymer and the bleeding did not recur. Most post-operative bleeds can be managed with bedside or intraoperative interventions. However, pseudoaneurysms should be considered in the differential diagnosis of recurrent bleeds refractory to surgical control.
Extension of the facial artery musculomucosal flap to reconstruct a defect of the soft palate
Published in Journal of Plastic Surgery and Hand Surgery, 2011
Juergen H. Dolderer, Alan J. Hussey, Wayne A. Morrison
Reconstruction after resection of a large oropharyngeal tumour poses a difficult challenge. This case illustrates an extension of the previously described facial artery musculomucosal (FAMM) flap, whereby a defect of the soft palate is replaced with a similar trilaminar structure in the form of irradiated, redundant lower lip. This allows not only the treatment of the palatal defect, but also management of dribbling secondary to a marginal mandibular palsy.
Superselective angiographic embolization for intractable epistaxis
Published in Acta Oto-Laryngologica, 2008
Kenji Fukutsuji, Suetaka Nishiike, Teruhito Aihara, Masako Uno, Tamotsu Harada, Masayuki Gyoten, Shigeki Imai
Conclusions. Routine embolization of the ipsilateral facial artery (FA) is effective because of the high success rate. The use of different embolic materials for the internal maxillary artery (IMA) and the FA was considered safe because of the absence of major complications. Objective. To evaluate outcomes of routine embolization of the FA as well as the IMA ipsilateral to the bleeding site for intractable epistaxis, and outcomes using different embolic materials for the FA and the IMA. Patients and methods. Twenty-two patients with intractable epistaxis who underwent superselective embolization were retrospectively analyzed with a mean follow-up of 7 months. The FA and the IMA ipsilateral to the bleeding site were embolized. Two embolic materials, gelatin sponge and microcoils, were used for the IMA and the FA, respectively. Results. The short-term success rate within the first 7 days was 77.3% (17/22). The long-term success rate was 95.5% (21/22). There were no major complications in 22 cases. Minor complications occurred in 13 cases (59%). These minor complications usually did not last more than a week and most resolved within a day.
Related Knowledge Centers
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