title: Direct carotid cavernous fistula after submucous resection of the nasal septum.
abstract: A carotid cavernous fistula (CCF) is an abnormal arteriovenous anastomosis between the carotid artery and the cavernous sinus. Etiologies of this condition reported in the literature so far include facial trauma, rupture of an intracavernous aneurysm of the carotid artery, Ehler-Danlos syndrome and fibromuscular dysplasia of the cerebral arteries. Such fistulae were reported as complications of rhinoplasty, transsphenoidal surgery, embolization of cavernous sinus meningioma, and rhinocerebral mucormycosis. CCF may also occur spontaneously in children or as a congenital malformation. However, to our knowledge, submucous resection of the nasal septum has not been reported before to cause direct carotid-cavernous fistula. CT and angiographic findings are presented and a review of the literature for reported causes of CCF is made as well as a brief discussion of the possible pathophysiology.
authors.affiliation: Department of Internal Medicine, American University of Beirut Medical Center, Lebanon.
authors.forename: A R
authors.initials: AR
authors.lastname: Bizri
authors.forename: M
authors.initials: M
authors.lastname: al-Ajam
authors.forename: G
authors.initials: G
authors.lastname: Zaytoun
authors.forename: A
authors.initials: A
authors.lastname: al-Kutoubi
mesh_terms: D000328:Adult; D000792:Angiography; D020216:Carotid-Cavernous Sinus Fistula / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D009300:Nasal Septum / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis; D014057:Tomography, X-Ray Computed