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External Carotid Artery Ligation for Perioperative Bleeding Control on Maxillectomy of a Squamous Cell Carcinoma Patient

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¾çÀ翵 ( Yang Jae-Young ) - Pusan National University School of Dentistry Department of Oral and Maxillofacial Surgery
ÀåÈÆ ( Jang Hun ) - Pusan National University School of Dentistry Department of Oral and Maxillofacial Surgery
À¯¹ÌÇö ( Ryu Mi-Heon ) - Pusan National University School of Dentistry Department of Oral Pathology
Ȳ´ë¼® ( Hwang Dae-Seok ) - Pusan National University School of Dentistry Department of Oral and Maxillofacial Surgery
±è¿í±Ô ( Kim Uk-Kyu ) - Pusan National University School of Dentistry Department of Oral and Maxillofacial Surgery

Abstract


To accurately determine the resection margin for maxillary cancer, it is important to closely examine the extent of tumor infiltration into the maxilla, nasal cavity, maxillary sinus, palate, and surrounding tissues. Various methods have been described for the resection of maxillary tumors, such as alveolectomy, partial maxillectomy, subtotal maxillectomy, total maxillectomy, and extended maxillectomy. The objective of this study was to introduce external carotid artery (ECA) ligation on the ipsilateral side, a perioperative bleeding control method with fewer complications. Incidence of major bleeding during maxillectomy is a rare but potentially life-threatening complication. Cases of temporary bleeding from an internal maxillary artery or other sites can be stopped, packed, and compressed. However, bleeding control is eventually achieved by ligation of the ECA or selective embolization. Herein, we report the case of a 60-year-old male with squamous cell carcinoma of the right maxilla, which was eventually treated with subtotal maxillectomy along with an elective ECA ligation for intraoperative bleeding control. The procedure produced no preoperative or postoperative bleeding. ECA ligation is a simple, effective, safe, and (at the operator¡¯s discretion) recommended method of perioperative bleeding control during maxillectomy.

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Squamous cell carcinoma; Subtotal maxillectomy; External carotid artery; Ligation

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