A rare complication of an Arteriovenous shunt after bimaxillary surgery

A R Bouter; P A van Twisk; P J van Doormaal; B J Emmer; M J Koudstaal

doi:10.1016/j.jpra.2021.02.009

A rare complication of an Arteriovenous shunt after bimaxillary surgery

JPRAS Open. 2021 Mar 11:28:90-96. doi: 10.1016/j.jpra.2021.02.009. eCollection 2021 Jun.

Authors

A R Bouter¹, P A van Twisk¹, P J van Doormaal², B J Emmer³, M J Koudstaal¹

Affiliations

¹ Department of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, Netherlands.
² Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Netherlands.
³ Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Netherlands.

Abstract

The most common complications following bimaxillary surgery are inferior alveolar nerve damage, hemorrhage, and relapse. Severe complications are rare, but few cases of vascular arteriovenous malformation, cavernous sinus thrombosis, formation of an aneurysm or arteriovenous shunting are reported in literature. We present a case of a 20-year-old male patient who developed a right sided tinnitus and visible pulsations close to the mandibular angle on the right side after bimaxillary surgery. CT-angiography and subsequent digital subtraction angiography (DSA) six months after surgery showed an arteriovenous fistula (AVF) from the external carotid artery to the external jugular vein. The AVF was treated by endovascular coil embolization. At six months after intervention there were no residual complaints. We discuss the possible etiology and trauma mechanisms that might have caused this pathology and present recommendations to avoid this type of complications.

Keywords: Arteriovenous fistula; Bimaxillary surgery; Embolization; Vascular complications.

Publication types

Case Reports