In the field of oromaxillofacial surgery, it is not common to meet arteriovenous malformation(AVM) patients. AVMs are the result of congenital abnormality, or the result of trauma of adjacent vessels. This patients need special care in surgical procedure. Also, they need management include clinical, radiographic, and angiographic assessment. We report a case of the AVM in right maxillary artery, who embolized PVA and obtained good result.
Angiography ; Arteriovenous Malformations* ; Congenital Abnormalities ; Humans ; Maxillary Artery

Nasopharyngeal angiofibroma occurs predominantly in adolescent males, and shows frequent epistaxis, nasal obstruction, mouth breathing and facial deformities. Because its recurrence rate ranges from 7.1% to 50%, complete removal of this tumor is important to prevent recurrence. Traditionally, many surgical approaches including lateral rhinotomy and transpalatal approaches have been used for this tumor depending on the site and size of the tumor. If the tumor is small and present within the nasal cavity, endoscopic approach can be used. But when tumor has extended to pterygopalatine fossa, endoscopic approach has some limitations for complete removal. In such a case, we have used a transantral microsurgery and transnasal endoscopic combined approach. We present two cases of nasopharyngeal angiofibromas treated by deep transantral microsurgery and intranasal endoscopic approach. By this approach, we have ligated the internal maxillary artery after emboliztion of intenal maxillary artery and could remove the tumor completely. Two patients have been followed over 12 months without recurrence.
Adolescent ; Angiofibroma* ; Congenital Abnormalities ; Epistaxis ; Humans ; Male ; Maxillary Artery ; Microsurgery* ; Mouth Breathing ; Nasal Cavity ; Nasal Obstruction ; Pterygopalatine Fossa* ; Recurrence

We report a new approach of embolization in a 15-year-old boy that presented with a massive hemorrhage from a maxillary arteriovenous malformation. Re-bleeding occurred after emergent ligation of the external carotid artery. The bleeding was successfully controlled by embolization via the superficial temporal artery.
Adolescent ; Arteriovenous Malformations/*therapy ; Carotid Artery, External/surgery ; Embolization, Therapeutic/*methods ; Hemorrhage/etiology/therapy ; Humans ; Ligation ; Male ; Maxillary Artery/*abnormalities ; Temporal Arteries

A Le Fort I osteotomy is a common procedure for correcting dental and facial deformities in orthognathic surgery. In rare cases, a delayed hemorrhage can occur as early as several hours or up to 12 weeks, postoperatively. The most frequently involved blood vessels in a delayed hemorrhage are the descending palatine artery, the internal maxillary artery, and the pterygoid venous plexus of veins. Intraoral bleeding accompanied by severe epistaxis in these cases makes it difficult to locate the precise bleeding focus. Eventual uncontrolled bleeding would require Merocel packing or surgical intervention. In general, a severe late postoperative hemorrhage is most effectively managed by angiography and embolization. Herein we describe a delayed hemorrhage case in which the cause was not evident on angiography. We were able to detect the bleeding point through an endoscopic nasal approach and treat it using direct cauterization.
Aneurysm, False ; Angiography ; Arteries ; Blood Vessels ; Cautery ; Congenital Abnormalities ; Epistaxis ; Hemorrhage ; Maxillary Artery ; Orthognathic Surgery ; Osteotomy ; Postoperative Complications ; Postoperative Hemorrhage ; Veins