1. Vladimir Biočanin, Stomatoloski fakultet, Pančevo, Serbia
Introduction
Alveolar antral artery presents anastomotic blood vessel which connects infraorbital and posterior superior alveolar arteries. Surgical procedures applied to anterior maxillary sinus wall such as open sinus lift, Caldwell-Luc surgery, Le Fort I osteotomy and osteosynthesis for the treatment of maxillary fractures, may involve this artery. Surgical manipulation of this artery during these procedures can lead to hemorrhage¹. The aim of this report is to present unusual position and course of alveolar antral artery.
Patient`s report
A 35 year-old male patient with chronic maxillary sinusitis accompanied by oroantral fistula was refered by general dental practitioner to the Clinic of Oral Surgery, School of Dental Medicine, University of Belgrade. Patient complained to dull pain in the region of right side of midface, which started few days after the extraction of tooth #16. In addition, he stated that water run through nostrils whenever tried to drink. The clinical examination and radiographic analysis confirmed the diagnosis of right maxillary chronic sinusitis (Figure 2 – black arrow) with oroantral fistula. The treatment plan included Caldwell- Luc lateral approach to maxillary sinus and complete removal of pathologicaly changed mucosa of the antrum. After raising the mucoperiosteal flap, the lateral window 1,5x2 cm was created in the anterior maxillary bony wall with round diamond bur. The bony window was removed and blood vessel 2 mm in diameter, that passes diagonaly, was seen, laying on the sinus mucosa (Figure 1). The blood vessel ligation was done with resorptive sutures (Vicriyl®, 3-0, Ethicon, USA) at both ends, in order to prevent possible hemorrhage due to its possible injury.
Conclusions
Alveolar antral artery is usually located within the bony canal in anterior maxillary wall. Our patient was the case where alveolar antral artery was not situated in bony wall. In addition, the course of the artery was not horizontal, as usual², but more diagonal. The 3D image showed just slight impression of blood vessel in anterior bony wall of right maxillary sinus (Figure 2- yellow arrow).
This artery could be accidentally injured during surgical procedures on the lateral maxillary sinus wall, such as open sinus lift surgery, horizontal osteotomy of the maxilla, Le Fort I fracture treatment, and Caldwell-Luc surgeries¹. This case showed that careful Caldwell- Luc surgery procedure eliminate possible injury to alveolar antral artery.
Ključne reči :
Tematska oblast:
SIMPOZIJUM B - Biomaterijali i nanomedicina
Datum:
15.06.2015.
Contemporary Materials 2015 - Savremeni Materijali
