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An unusual complication of epistaxis
1University of Cape Town, Medical School, Observatory, Cape, South Africa.
The Journal of Laryngology and Otology
|February 1, 1988
Summary
A patient developed facial nerve palsy after carotid artery ligation for nosebleeds. This suggests a potential complication involving blood flow to the facial nerve.
Area of Science:
- Neurology
- Vascular Surgery
- Otolaryngology
Background:
- Epistaxis, or nosebleeds, can be severe and require surgical intervention.
- External carotid artery ligation is a procedure used to control intractable epistaxis.
- Facial nerve palsy is a condition affecting facial movement.
Observation:
- A 25-year-old male presented with complete left-sided facial nerve palsy 10 days post-left external carotid artery ligation.
- The patient had no pre-existing bleeding or clotting disorders.
- The palsy occurred on the same side as the ligation procedure.
Findings:
- The development of facial nerve palsy is a rare but potential complication following external carotid artery ligation.
- It is hypothesized that thrombosis or embolus in the petrosal branch of the middle meningeal artery led to ischemia.
- Ischemia of the intratemporal portion of the facial nerve resulted in nerve degeneration.
Implications:
- This case highlights a potential mechanism for iatrogenic facial nerve injury.
- Vigilance for neurological complications is warranted after head and neck vascular procedures.
- Further research may explore preventative strategies or diagnostic markers for this complication.