Ischemic necrosis of nose and palate after embolization for epistaxis. A case report.
This paper reports the case of a 50-year-old man who underwent superselective embolization after severe posterior rhinorrhagia caused by hypertension. Twelve hours after the procedure, left-sided hemiparesis and right-sided facial nerve paresis developed, followed by ulceration and necrosis of the soft palate, diaphragm, and right nasal ala. Reconstruction was implemented with porous polyethylene for the nasal pyramid, a forehead flap and a mucosal flap from the oral vestibulum for polyethylene coverage, and a rotational palatal flap for closure of the oroantral fistula. Exposure of the material occurred after 4 weeks, and removal was followed by satisfactory maintenance of the shape and function of the nose. Postembolization necrosis is a rare complication of the area, and there are very few similar reports in the literature.
Ntomouchtsis
Aris
A
Aristotle University of Thessaloniki, School of Dentistry, Thessaloniki, Greece.
Venetis
Gregory
G
Zouloumis
Lambros
L
Lazaridis
Nicolas
N
D004621:Embolization, Therapeutic / Q000009:adverse effects*; D004844:Epistaxis / Q000628:therapy*; D005155:Facial Nerve Diseases / Q000209:etiology; D005158:Facial Paralysis / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000209:etiology*; D008297:Male; D008438:Maxillary Artery; D008875:Middle Aged; D009061:Mouth Mucosa / Q000637:transplantation; D009336:Necrosis; D009666:Nose / Q000098:blood supply*; D009668:Nose Diseases / Q000601:surgery; D016155:Oral Fistula / Q000601:surgery; D010160:Palate, Soft / Q000098:blood supply*; D010291:Paresis / Q000209:etiology; D020959:Polyethylene; D011474:Prosthesis Design; D019919:Prosthesis Implantation; D019651:Plastic Surgery Procedures / Q000379:methods; D016156:Respiratory Tract Fistula / Q000601:surgery; D016038:Skin Transplantation; D013524:Surgical Flaps
D020959:Polyethylene