Acquired arteriovenous fistula associated with traumatic oroantral fistula: endovascular treatment

Head Neck. 2013 May;35(5):E138-41. doi: 10.1002/hed.21978. Epub 2012 Jan 31.

Abstract

Background: Oroantral fistulas are pathologic connections between the oral cavity and the maxillary sinus. Arteriovenous fistulas are abnormal connections between an artery and a vein with no intervening capillary network.

Methods: We present an extremely rare case of barotrauma-related oroantral fistula with an associated arteriovenous fistula between the internal maxillary artery and the ophthalmic venous system.

Results: The patient developed an oroantral fistula from barometric pressure changes in the setting of sinusitis. After closure and revision of the oroantral fistula, he developed proptosis and chemosis. Angiography revealed an arteriovenous fistula between the internal maxillary artery and the ophthalmic venous drainage system in the area of the oroantral fistula, which was treated with endovascular embolization.

Conclusions: Arteriovenous fistulas may accompany oroantral fistulas created by trauma or surgery and should be considered in patients presenting with chemosis and proptosis. Treatment with embolization should be performed before surgical intervention.

Publication types

  • Case Reports

MeSH terms

  • Aerospace Medicine
  • Aged, 80 and over
  • Air Pressure*
  • Arteriovenous Fistula / complications*
  • Arteriovenous Fistula / diagnostic imaging
  • Arteriovenous Fistula / therapy*
  • Cerebral Angiography
  • Embolization, Therapeutic
  • Endovascular Procedures / methods*
  • Humans
  • Male
  • Oroantral Fistula / complications*
  • Oroantral Fistula / etiology
  • Sinusitis / complications