Carotid artery injury during mandibular distraction.
BACKGROUND
Mandibular distraction is an effective treatment for mandibular hypoplasia. Special care must be done while performing the corticotomies to prevent injuries to blood vessels or nerves nearby. A rare iatrogenic severe injury occurred while performing this operation.
A 3 year-old girl was operated upon to correct mandibular hypoplasia. A rotating saw was used to perform corticotomies in the mandibular angle. In the right side occurred acute bleeding and in the saw there was a piece of a blood vessel that was 15 mm long and 2 mm in diameter with an open lumen. Exploration of the neck revealed that the most distal segment of the internal carotid artery was severed, with a thrombus in the proximal end. The distal segment retracted into the temporal bone without bleeding. The proximal artery was ligated. After recovery she moved well. A computed tomogram was normal and further condition improved clinically.


CONCLUSIONS
This complication from the use of a rotary saw has not been documented previously and it must be prevented by using some protection behind the bone.
Sigler
Alicia
A
Estheticos clinic, Tijuana BC, Mexico.
Gutiérrez
Manuel
M
Harris
Alfredo
A
Capiz
Manuel
M
Uriarte
Francisco
F
D020212:Carotid Artery Injuries / Q000209:etiology*; D002341:Carotid Artery Thrombosis / Q000209:etiology; D002343:Carotid Artery, Internal; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D008334:Mandible / Q000601:surgery*; D019186:Mandibular Advancement / Q000009:adverse effects* / Q000295:instrumentation; D008844:Micrognathism / Q000601:surgery; D019857:Osteogenesis, Distraction / Q000009:adverse effects*