Ear, nose, & throat journal
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Review Case Reports
Sphenopalatine artery pseudoaneurysm after endoscopic sinus surgery: a case report and literature review.
Previously reported cases of iatrogenic sphenopalatine artery (SPA) pseudoaneurysm have occurred only after trans-sphenoidal surgery for pituitary tumors or maxillofacial surgery. In this article, the author presents what to the best of her knowledge is the first reported case of an SPA pseudoaneurysm that developed following endoscopic sinus surgery (ESS). The patient was a 76-year-old woman with myelodysplastic syndrome who presented with a 6-month history of unilateral sinus symptoms. ⋯ The pathogenesis may include intraoperative trauma, infection, pressure necrosis from packing, or a combination of these factors. Optimal management includes either ligation or embolization, depending on anatomic, patient, staff, and resource factors. The author reviews the pertinent anatomy and the pathophysiology, diagnosis, management, and prevention of this rare complication.