Purpose : A life-threatening hemorrhage resulted from severe facial fracture is rare, but it needs a prompt and aggressive treatment. Especially, a massive oronasal bleeding combined with midfacial fracture may resulted from rupture of internal maxillary artery. As a radiologic intervention has developed recently, its use has increased for managing this case. We reviewed its usefullness with our experiences and literatures.
Method : A retrospective review was performed to determine the usefulness of transcatheter arterial embolization in patients with panfacial trauma. If the vital signs were unstable, cardiopulmonary resuscitation was performed. Then we did nasal packing and electrocautery for oronasal bleeding and checked all injured region by radiologic study including CT. If oronasal bleeding was persistent although primary management, radiologic intervention was performed. 10 patients got transcatheter arterial embolization and bleeding focus could be controlled by embolization with polyvinyl alcohol and gelfoam.
Result : After intervention, the vital signs became stable and there was no complications from embolization on follow-up for 6 months. Also patients could recover through appropriate operation.
Conclusion : Transcatheter arterial embolization for maxillofacial injury has many advantages for doctor and patient. First, it hurts less than a compression device or operation, which are other ways to treat oronasal bleeding. Second, it doesn't need a general anesthesia. And through a single procedure not only we can know an accurate bleeding point, but also we can stop bleeding by embolization.