Traumatic Carotid-Cavernous Fistula as a sequela of Mandibular Fracture

Traumatic carotid-cavernous fistula(CCF) is an uncommon situation resulting from trauma. The blood shunted from the internal carotid artery to the cavernous sinus results in pulsation exophthalmos,orbital headache, bruit, loss of visual acuity, diplopia, ophthalmoplegia. We were recently faced with such a case. The patient sustained fracture of the mandible during sports activity. Five months later, all the classic signs and symptoms of CCF had appeared. A carotid angiography confirmed the presence of a CCF. The management was achieved intravascularly by platinum electrothrombosis embolization. The main signs and symptoms of the CCF had resolved, but the patient remained in a visual loss of affected eye.

A CASE REPORT ON THE SURGICAL TREATMENT FOR THE ECTROPION AS A COMPLICATION OF RECONSTRUCTION OF BLOW-OUT FRACTURE

Ectropion is a drooping or eversion of the lower eyelid as a result of lower lid laxity, canthal tendon laxity, or cicatrix formation from scarring. Ectropion can also be congenital or develop with aging. This complication can arise from primary trauma to the lower lid apparatus or as a result of unfavorable healing and scar contracture. To prevent development of ectropion, a careful attention in case of operation for orbital frature repair or blepharoplasty is necessary. Especially, excessive dissection or retraction of skin and orbicularis muscle should be avoided, and formation of edema and hematoma should be prevented by complete hemostasis. It might be helpful to massage on the eyelid frequently. In spite of endeavors mentioned above, lareral canthoplasty or skin graft must be performed when postoperative ectropion is occurred. With literature review the authors present a case report that good clinical result is achieved by lateral tarsal strip procedure on cicatricial ectropion caused by a complication of reconstruction of blow-out fracture.