Stab Injury to the Preauricular Region With Laceration of the External Carotid Artery Without Involvement of the Facial Nerve: a Case Report
| Autor: | Diogo Pais, João Goyri-O'Neill, Giovanni Pelliccia, José Videira-Castro, Maria Angélica-Almeida, Diogo Casal, Diogo Carrola-Gomes |
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| Přispěvatelé: | NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM) |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
External carotid artery lcsh:Medicine Case Report physical examination Lacerations Neck/diagnostic imaging 0302 clinical medicine Carotid Artery Injuries/surgery CHLC CPR 030223 otorhinolaryngology glass adult General Medicine carotid artery injury Facial nerve Parotid gland medicine.anatomical_structure Treatment Outcome priority journal Carotid Artery External Wounds Stab/surgery external carotid artery Tamponade Anatomy medicine.symptom Lacerations/surgery Artery Adult Stab wound medicine.medical_specialty laceration rare disease Wounds Stab Dissection (medical) Trauma Article Carotid Artery External/anatomy & histology Lesion 03 medical and health sciences preauricular stab injury male SDG 3 - Good Health and Well-being medicine.artery Case report medicine Cadaver Humans human business.industry lcsh:R Wound 030208 emergency & critical care medicine Facial Nerve/anatomy & histology bleeding medicine.disease Surgery Carotid Artery Injuries business Tomography X-Ray Computed Neck Carotid artery wound care |
| Zdroj: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) Agência para a Sociedade do Conhecimento (UMIC)-FCT-Sociedade da Informação instacron:RCAAP Journal of Medical Case Reports, Vol 11, Iss 1, Pp 1-7 (2017) Journal of Medical Case Reports |
| Popis: | Background: Open injuries to the face involving the external carotid artery are uncommon. These injuries are normally associated with laceration of the facial nerve because this nerve is more superficial than the external carotid artery. Hence, external carotid artery lesions are usually associated with facial nerve dysfunction. We present an unusual case report in which the patient had an injury to this artery with no facial nerve compromise. Case presentation: A 25-year-old Portuguese man sustained a stab wound injury to his right preauricular region with a broken glass. Immediate profuse bleeding ensued. Provisory tamponade of the wound was achieved at the place of aggression by two off-duty doctors. He was initially transferred to a district hospital, where a large arterial bleeding was observed and a temporary compressive dressing was applied. Subsequently, the patient was transferred to a tertiary hospital. At admission in the emergency room, he presented a pulsating lesion in the right preauricular region and slight weakness in the territory of the inferior buccal branch of the facial nerve. The physical examination suggested an arterial lesion superficial to the facial nerve. However, in the operating theater, a section of the posterior and lateral flanks of the external carotid artery inside the parotid gland was identified. No lesion of the facial nerve was observed, and the external carotid artery was repaired. To better understand the anatomical rationale of this uncommon clinical case, we dissected the preauricular region of six cadavers previously injected with colored latex solutions in the vascular system. A small triangular space between the two main branches of division of the facial nerve in which the external carotid artery was not covered by the facial nerve was observed bilaterally in all cases. Conclusions: This clinical case illustrates that, in a preauricular wound, the external carotid artery can be injured without facial nerve damage. However, no similar description was found in the reviewed literature, which suggests that this must be a very rare occurrence. According to the dissection study performed, this is due to the existence of a triangular space between the cervicofacial and temporofacial nerve trunks in which the external carotid artery is not covered by the facial nerve or its branches. © 2017 The Author(s). publishersversion published |
| Databáze: | OpenAIRE |
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