Aylin ERYILMAZ, Yeşim BASAL, Ceren GÜNEL, Kutsi KÖSEOĞLU

Facial Artery Aneurysm After Tonsillectomy, an Emergency Case

In persistent bleedings after tonsillectomy despite all surgical procedures, facial artery aneurysm should be kept in mind. A case is presented with this rare situation. 12-year-old girl refers to her physician with bleeding four days after tonsillectomy in an outer center. Surgical control of bleeding from the left tonsillectomy area is done in this center. After one week the bleeding begins again from the same place. She is hospitalized in an other hospital for one week but no bleeding occured in this time. A few days after discharge, she is refered to our hospital with an intense bleeding from oral cavity. Magnetic resonance angiography revealed left facial artery aneurysm. The facial artery aneurysm was filled with coil stents in the radiology department . After this procedur there was no bleeding in a one week hospitalization. Five days after discharge, the patient refered us with bleeding. This time facial artery blood flow was completely obliterated with coil stent. The patient had no bleeding in her two and six months control. In persitent bleedings after tonsillectomy aneurysms should be thought necessarily because they can be life-threatening.

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1. Atmaca S, Belet U, Baris S. Post-tonsillectomy pseudoaneurysm of the linguofacial trunk: An ENT surgeon’s nightmare. Int J Pediatr Otorhinolaryngol Extra 2012; 7: 12-4.

2. Van Cruijsen N, Gravendeel J, Dikkers FG. Severe delayed posttonsillectomy haemorrhage due to a pseudoaneurysm of the lingual artery. Eur Arch Otorhinolaryngol 2008; 265: 115-7.

3. Karas DE, Sawin RS, Sie KC. Pseudoaneurysm of the external carotid artery after tonsillectomy. A rare complication. Arch Otolaryngol Head Neck Surg 1997 Mar; 123: 345-7.

4. Unal OF, Hepgül KT, Turantan MI, Bozboga M, Yazicioglu E. Extracranial carotid artery aneurysm in a child misdiagnosed as a parapharyngeal abscess: a case report. J Otolaryngol 1992; 21: 108-11.

5. Pourhassan S, Grotemeyer D, Fokou M, Heinen W, Balzer K, Ramp U, et al. Extracranial carotid arteries aneurysms in children: single-center experiences in 4 patients and review of the literature. J Pediatr Surg 2007; 42: 1961-8.

6. Weber R, Keerl R, Hendus J, Kahle G. The emergency: traumatic aneurysm in the area of the head-neck. Laryngorhinootologie 1993; 72: 86-90.

7. Manzato L, Trivelato FP, Alvarenga AY, Rezende MT, Ulhôa AC. Endovascular treatment of a linguofacial trunk pseudoaneurysm after tonsillectomy. Braz J Otorhinolaryngol 2013; 79: 524.