Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-12-01T01:11:20.780Z Has data issue: false hasContentIssue false
  • English
  • Français

Oroantral fistula: a complication of transantral ligation of the internal maxillary artery for epistaxis

Published online by Cambridge University Press:  29 June 2007

M. K. Morgan  and
C. P. Aldren
M. K. Morgan*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Freeman Hospital, Newcastle upon Tyne, UK.
C. P. Aldren
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Freeman Hospital, Newcastle upon Tyne, UK.
*
Address for correspondence: Mrs M. K. Morgan, Department of Otolaryngology–Head and Neck Surgery, Freeman Group of Hospitals, High Heaton, Newcastle upon Tyne NE7 7DN.
Get access Rights & Permissions [Opens in a new window]

Abstract

Transantral ligation of the internal maxillary artery (IMAX) is a well-described option for surgical management of posterior epistaxis not controlled by anterior and posterior packing. Advocates for this procedure argue that it reduces the morbidity, length of hospital stay and financial cost associated with prolonged nasal packing. The procedure is carried out through a Caldwell-Luc approach and the IMAX is clipped in the pterygomaxillary fossa. Fashioning of a nasoantral window is optional and its inclusion usually depends on the integrity of the sinus ostium. The commonest complications of transantral IMAX ligation occur when local structures including the inferior orbital and anterior superior alveolar nerves are damaged. The incidence of oroantral fistula following IMAX ligation is very low but those cases reported have been associated with the failure to create a nasoantral drainage window. We report two cases of persistent oroantral fistula complicating transantral internal maxillary artery ligation. No nasoantral window was fashioned in either of these cases.

Keywords

Oroantral fistulaEpistaxisPost-operative complications
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 111 , Issue 5 , May 1997 , pp. 468 - 470
Copyright
Copyright © JLO (1984) Limited 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Allen, G. W. (1970) Ligation of the internal maxillary artery for epistaxis. Laryngoscope 80: 915–923.CrossRefGoogle ScholarPubMed
Arnes, E., Anke, I. M., Mair, W. S. (1985) A comparison between middle and inferior meatal antrostomy in the treatment of chronic maxillarysinus infection. Rhinology 23: 65–69.Google Scholar
Benninger, M. S., Kaczor, J., Stone, C. (1993) Natural ostiotomy vs. inferior antrostomy in the management of sinusitis: an animal model. Otolaryngology–Head and Neck Surgery 109: 1034–1042.CrossRefGoogle ScholarPubMed
Breda, S. D., Choi, I. S., Persky, M. S., Weiss, M. (1989) Embolization in the treatment of epistaxis after failure of internal maxillary artery ligation. Laryngoscope 99: 809–813.CrossRefGoogle ScholarPubMed
Chandler, J. R., Serrins, A. J. (1965) Transantral ligation of the internal maxillary artery for epistaxis. Laryngoscope 75: 1151–1159.CrossRefGoogle ScholarPubMed
DeFreitas, J., Lucente, F. E. (1988) The Caldwell-Luc procedure: Institutional review of 670 cases: 197–1985. Laryngoscope 98: 1297–1300.CrossRefGoogle Scholar
Jerome, C. E. (1994) Maxillary root fracture caused by sinus surgery: case report. Endodontics and Dental Traumatology 10: 286–288.CrossRefGoogle ScholarPubMed
Johnson, L. P., Parkin, J. L. (1976) Blindness and total ophthalmoplegia. A complication of transantral ligation of the internal maxillary artery for epistaxis. Archives of Otolaryngology 102: 501–504.CrossRefGoogle ScholarPubMed
Lin, S. (1994) Arterial embolization leading to fatal cerebral infarction. Chinese Journal of Otolaryngology 29(4): 209–210.Google ScholarPubMed
Lofgren, R. H. (1971) Surgery of the pterygomaxillary fossa. Archives of Otolaryngology 94: 516–524.CrossRefGoogle ScholarPubMed
Low, W. K. (1995) Complications of the Caldwell-Luc operation and how to avoid them. Australian and New Zealand Journal of Surgery 65:582–584.CrossRefGoogle Scholar
Macbeth, R. (1968) Caldwell-Luc operation 1952–1966. Archives of Otolaryngology 87: 84–90.Google ScholarPubMed
McDonald, T., Pearson, B. (1980) Follow-up on maxillary artery ligation for epistaxis. Archives of Otolaryngology 106: 635–638.CrossRefGoogle ScholarPubMed
Metson, R., Lane, R. (1988) Internal maxillary artery ligation of epistaxis: An analysis of failures. Laryngoscope 98: 760–764.CrossRefGoogle ScholarPubMed
Murray, J. A. M. (1988) In Logan Turner's Diseases of the Nose, Throat and Ear, 10th Edition. Butterworth, London, pp 30–33.Google Scholar
Murray, J. P. (1983) Complications after treatment of chronic maxillary sinus disease with Caldwell-Luc procedure. Laryngoscope 93: 282–284.CrossRefGoogle ScholarPubMed
Nair, K. (1982) Transantral ligation of the internal maxillary artery. Laryngoscope 92: 1060–1063.CrossRefGoogle ScholarPubMed
Pearson, B. W., MacKenzie, R. G., Goodman, W. S. (1969) The anatomical basis of transantral ligation of the maxillary artery in severe epistaxis. Laryngoscope 79: 969–984.CrossRefGoogle ScholarPubMed
Premachandra, D. J., Sergeant, R. J. (1993) Dominant maxillary artery as a cause of failure in maxillary artery ligation for posterior epistaxis. Clinical Otology 18 (1): 42–47.CrossRefGoogle ScholarPubMed
Rosnagle, R. S., Yanagisawa, E., Smith, H. W. (1973) Specific vessel ligation for epistaxis: Survey of 60 cases. Laryngoscope 83: 517–525.CrossRefGoogle ScholarPubMed
Schaitkin, B., Strauss, M., Houck, J. R. (1987) Epistaxis: Medical versus surgical therapy: Comparison of efficacy, complications and economic considerations. Larynoscope 97: 1392–1396.CrossRefGoogle ScholarPubMed
Seiffert, A. (1928) Unterbindung der Arteria maxillaris interna. Zeitschrifi fur Hals-, Nasen-, und Ohrenheilkunde 22: 323–325.Google Scholar
Simpson, G. T., Janfara, P., Becher, G. D. (1982) Transantral sphenopalatine artery ligation. Laryngoscope 92: 1001–1005.CrossRefGoogle ScholarPubMed
Small, M., Maran, A. G. D. (1984) Epistaxis and arterial ligation. Journal of Laryngology and Otology 98: 281–284.CrossRefGoogle ScholarPubMed
Spafford, P., Durham, J. S. (1992) Epistaxis: Efficacy of arterial ligation and long-term outcome. Journal of Otolaryngology 21: 4252–256.Google ScholarPubMed
Stammberger, H., Posawetz, W. (1989) Functional endoscopicsinus surgery. Concept, indications and results of the Messerklinger technique. European Archives of OtoRhino-Laryngology 247: 63–76.Google Scholar
Stepnick, D. W., Maniglia, A. J., Bold, E. L.,Maniglia, J. V. (1990) Intraoral-extramaxillary sinus approach for ligation of the maxillary artery: An anatomic study with clinical correlates. Laryngoscope 100: 1166–1170.CrossRefGoogle ScholarPubMed
Wetmore, S. J., Scrima, L., Hiller, F. C. (1988) Sleep apnea in epistaxis patients treated with nasal packs. Otolaryngology–Head and Neck Surgery 98 (6): 596–599.CrossRefGoogle ScholarPubMed
Winstead, W. (1966) Sphenopalatine artery ligation: An alternativeto internal maxillary artery ligation for intractable posterior epistaxis. Laryngoscope 106: 667–669.CrossRefGoogle Scholar