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At least 19 recordsLinked to original sources
PubMed1993

Dominant maxillary artery as a cause of failure in maxillary artery ligation for posterior epistaxis.

Ligation of the maxillary artery is a logical and effective method for the arrest of severe uncontrollable posterior epistaxis. The failure rates for arrest of haemorrhage are given in the literature as 10-13%. In our centre, over the last 9 years, 23 patients have undergone maxillary artery ligation to control epistaxis without a failure. Bilateral maxillary artery ligation was carried out whenever the maxillary artery of the bleeding side was found to be of small diameter. To investigate whether there is an asymmetry in the size of the maxillary arteries we performed 13 cadaveric dissections. In 6 of the cadavers one maxillary artery was significantly larger than the other. This fact has hitherto not been observed by otolaryngologists or anatomists. Failure to arrest haemorrhage may have resulted from ligation of the non-dominant maxillary artery with consequent opening of cross-anastomoses from the dominant side.

Adult↗
PubMed1998

[The maxillary artery embolization in the management of recurrent epistaxis].

The management of recurrent epistaxis, especially posterior epistaxis, is difficult. Anterior and posterior nasal packing constitutes the initial treatment. Ligation of the ethmoid arteries and maxillary artery is the next step if the previous methods fails. We have described three cases with recurrent epistaxis; all underwent successful diagnostic angiography and therapeutic embolization of the maxillary artery. The role of embolization in the management of persistent epistaxis has been discussed.

Adult↗
PubMed1989

Embolization in the treatment of epistaxis after failure of internal maxillary artery ligation.

Internal maxillary artery ligation is effective in treating epistaxis. Occasionally a patient may continue to hemorrhage after this procedure. Evaluation of postoperative angiograms reveals several factors accounting for the failure of internal maxillary artery ligation. These factors include incomplete ligation of vessels, alternative dominance of vessels, and reconstitution of flow through collaterals. Eleven such patients have been successfully treated with angiography and embolization. There was one complication of skin slough in the region of the columella. Embolization is a useful modality in the management of these difficult cases.

Adult↗
PubMed1982

The effect of experimental ligation of the external carotid artery and its major branches on haemorrhage from the maxillary artery.

The effect of ligation of the external carotid artery and its major branches on blood flow from the maxillary artery was investigated in four Chacma baboons. The left common carotid artery and its branches were surgically exposed and the maxillary artery was isolated, sectioned and cannulated. Blood flow from the proximal segment of the maxillary artery was determined with and without occlusion of the common carotid artery, the external carotid artery above and below the origin of the linguo-facial trunk and the posterior auricular occipital trunk. Ligation of the external carotid artery below and above the origin of the lingual and facial arteries reduced maxillary artery blood flow by 40% and 73% respectively. Ligation of the external carotid artery above the origin of the lingual and facial vessels, together with ligation of the posterior auricular occipital trunk reduced maxillary artery blood flow by 99.2%. On the basis of these experimental findings, it is suggested that maxillary artery haemorrhage in man may be most effectively controlled by ligation of the external carotid artery in the retromandibular fossa, distal to the origin of the posterior auricular artery, combined with ligation of the superficial temporal artery at the root of the zygoma.

Animals↗
PubMed1994

Effect of multiple ligations of the external carotid artery and its branches on blood flow in the internal maxillary artery in dogs.

PURPOSE: The effect of occlusion of the external carotid system on blood flow of the internal maxillary artery was investigated in 16 dogs. METHODS: The external carotid system was occluded by ligation or clamping at different levels separately or simultaneously and the blood flow of the internal maxillary artery was measured with an electromagnetic flowmeter before and after each occlusion. RESULTS: The ligation of the external carotid artery below (low ligation) and above (high ligation) the origin of the occipital, lingual, and facial arteries reduced the blood flow by 61.1% and 71.5%, respectively. Low ligation together with ligation of the lingual artery reduced the blood flow by 73.5%. Multiple ligations (high and low ligations combined with ligations of the occipital, lingual, and facial arteries) reduced the blood flow by 81.8%. The internal maxillary artery was sectioned after the multiple ligations, and retrograde flow from the distal segment was studied. The flow was only a trace and could not be measured with the flowmeter. Total blood loss from both ends almost equaled the blood flow of the proximal segment, 18.2% of normal. CONCLUSIONS: Multiple occlusion appears to be the most effective treatment for hemorrhage from the initial part of the internal maxillary artery.

Animals↗
PubMed1996

[Treatment of postoperative "uncontrollable" nosebleed by embolization of the maxillary artery].

BACKGROUND: Embolization of the maxillary artery is a successful treatment, alternative in cases of recurrent severe nosebleeds when anterior and posterior nasal packing have failed to achieve permanent control. PATIENTS AND METHOD: Two cases of male patients are presented who suffered from severe nosebleeds after a submucous resection of the septum, electrocautery of the inferior turbinate, and submucosal conchotomy. Anterior and posterior nasal packing proved to be unsuccessful. Angiography of the internal and external carotid artery was performed and selective embolization of the mayillary artery with absorbable material followed. RESULTS: In both cases embolization was successful and uneventful. Twenty-four hours after treatment, the nasal packing was removed and no recurrence was observed. CONCLUSION: Selective embolization of the maxillary artery is a successful alternative for the treatment of severe recurrent nosebleeding-equally effective with surgical ligation of the bleeding arteries.

Adult↗
PubMed1991

[The topography of the maxillary artery within the infratemporal fossa].

The topographical anatomy of the maxillary artery in the infratemporal fossa is investigated. 194 preparations from 98 adult specimens are examined (53 male, 45 female). Our important findings are the following: 1. In 29 of 96 specimens (in 2 cases only one side was available) the maxillary artery is located on the outer side of the external pterygoid muscle on one side of the head whereas on the opposite side of the same head it is situated on the inner side of the external pterygoid muscle. 2. in our dissections the maxillary artery is running more frequently medial to the external pterygoid muscle (107 out of 194 preparations; 55.2%) 3. in 2 cases the relation of the maxillary artery to the branches of the mandibular nerve is considerable interesting. 4. An accessory meningeal artery is found in 9 cases (4.6%). 5. In 2 cases the maxillary artery perforates the lingual nerve.

Female↗
PubMed1999

[Important adjacent relationship of external maxillary artery and clinic significances].

OBJECTIVE: To investigate the important adjacent relationship of the external maxillary artery. METHODS: 60 pieces of complete head-neck samples were dissected layer by layer (only one side per sample), then the adjacent structures of the external maxillary artery, such as the submandibular gland, the anterior facial vein, the marginal mandibular branches of facial nerve and the submandibular lymphatic nodes were observed. RESULTS: 1. 60% of external maxillary artery lay on the bottom of submandibular gland, 38.3% went through the gland and 1.7% on the surface of the gland; 2. 90% of marginal mandibular branches of facial nerve went through the surface of external maxillary artery, 5% on the bottom and 5% encircled and gripped the artery; 3. 6.7% of anterior facial vein lay on the bottom of submandibular gland and accompanied external maxillary artery, 5% went through the gland and accompanied the artery, 88.3% went on the surface of the gland and didn't accompany the artery; 4. There were constant lymphatic nodes in front of and behind the external maxillary artery. CONCLUSION: The adjacent relationship of external maxillary artery is complex, and it is significant for doctors to know the above important structures around the artery.

Adolescent↗
PubMedDate not supplied

Occlusion of the external carotid and maxillary arteries in the horse to prevent hemorrhage from guttural pouch mycosis.

Balloon-tipped catheters were used to occlude the external carotid artery and its branches in nine horses with hemorrhage caused by guttural pouch mycosis. The internal carotid artery on the affected side was occluded simultaneously in four horses and had been occluded previously in two others. In three horses, a single balloon-tipped catheter was inserted in the external carotid artery beneath the floor of the guttural pouch and its tip was advanced blindly into distal branches. In one horse, the superficial temporal artery was occluded briefly during surgery by a balloon-tipped catheter so a catheter inserted into the external carotid artery could be diverted into the maxillary artery. In the other five horses, the external carotid artery was occluded proximally and the maxillary artery was occluded immediately caudal to the alar canal by a balloon-tipped catheter inserted into the major palatine artery. Serious postoperative hemorrhage did not occur in eight horses, but one horse that had a single balloon-tipped catheter inserted into the external carotid artery had profuse hemorrhage 11 days after surgery and was euthanatized. One horse was euthanatized because of persistent dysphagia. The only complication related to use of balloon catheters was a mild incisional infection in one horse. It was concluded that the external carotid and maxillary arteries must be occluded on both sides of the eroded segment to prevent hemorrhage from normograde and retrograde flow.

Animals↗
PubMed2003

The clinical anatomy of the maxillary artery in the pterygopalatine fossa.

PURPOSE: The purposes of this study were to delineate the maxillary artery and its branching arteries and to develop a classification of the various branching patterns by means of serial cadaver dissections of the pterygopalatine fossa region. MATERIALS AND METHODS: Fifteen Korean adult cadavers were used; 2 sides of each cadaver were examined, for a total of 30 sides. Before dissection of the pterygopalatine region, computed tomography scan was taken of 20 cadaver heads. Sectioned specimens of 9 sides of the cadaver heads in 3.0-mm thickness were made for this study. Then we dissected 21 sides of fresh cadavers under the microscope. In this investigation, we observed branching patterns of the third portion of the maxillary artery, a relationship of the terminal branches of the maxillary artery to the pterygomaxillary junction, and the course of descending palatine artery. Then we classified the branching patterns of the maxillary artery in the pterygopalatine fossa. RESULTS: From the pterygomaxillary junction to the pterygopalatine fossa region, the maxillary artery was usually branched into 5 arteries in the following order: posterior superior alveolar artery, infraorbital artery, artery of the pterygoid canal, descending palatine artery, and sphenopalatine artery. Of 21 cadavers, 18 showed this order (85.7%). There were 2 types of branching patterns of the posterior superior alveolar artery and the infraorbital artery. The average distance from the most inferior point of the pterygomaxillary junction to the posterosuperior alveolar artery, infraorbital artery, and descending palatine artery was 15.2, 32.2, and 24.8 mm, respectively. In most cases (95.2%), the greater and lesser palatine arteries were divided from the short descending palatine artery. According to the contours of the third portion of the maxillary artery, we classified them into 5 types: the "Y" type (19%), "intermediate" type (33.3%), "T" type (23.8%), and "M" type (14.3%). CONCLUSION: The results of this investigation show the common patterns of the maxillary artery.

Adult↗
PubMedDate not supplied

Transarterial coil embolization of the internal and external carotid and maxillary arteries for prevention of hemorrhage from guttural pouch mycosis in horses.

OBJECTIVES: To develop a transarterial coil embolization technique for occlusion of the internal carotid artery (ICA), external carotid artery (ECA), and maxillary arteries (MA) in normal horses and to evaluate this technique for prevention of hemorrhage in horses affected with guttural pouch mycosis. ANIMALS: Ten adult, normal horses and 4 horses with guttural pouch mycosis. METHODS: All horses had transarterial coil embolization of the rostral and caudal ICA, caudal MA, and rostral ECA. In 1 affected horse, an aberrant actively bleeding branch of the ECA was also occluded. Normal horses had a premortem angiogram, and were killed either at 1 or 2 weeks or 1, 2, or 3 months after the procedure. Specimens from the ICA, ECA and MA were evaluated by light microscopy. RESULTS: No surgical complications were observed, except 1 horse that developed laryngeal hemiplegia and 1 pilot horse that had embolization of the cerebral arterial circle. In normal horses, premortem angiography confirmed complete occlusion of all vessels, and coils were positioned as intended. All normal horses had partially maturing to mature, continuous thrombi occluding at the coils. In affected horses, no further episodes of epistaxis were observed. By day 60, all mycotic plaques had resolved without further treatment. Ophthalmic complications were not observed. CONCLUSION: Transarterial embolization provided a safe, rapid, and effective method for ICA, ECA, and MA occlusion in normal and affected horses. In affected horses, the technique was possible despite active bleeding, allowing adequate identification and occlusion of all sources of hemorrhage.

Angiography↗
PubMed1982

Anatomy of the maxillary artery into the pterygomaxillopalatine fossa.

The trajectory and ramifications of the maxillary artery near to and in the pterygomaxillopalatine (pterygopalatine, pterygomaxillar) fossa are reported by the authors through transmaxillary and endonasal microdissections of thirty heads from Brazilian males. They observed that always close to the maxillary tuberosity, the maxillary artery reaches the medial wall of the fossa, after tortuous and complex trajectory as a network around the nervous ramifications. They found on average of 11 branches from the maxillary artery in the fossa. The posterior superior alveolar and descending palatine arteries were observed as the largest branchs from the maxillary artery near to and in the fossa, while the thinnest branche was the artery of the round canal. The infraorbital and posterior superior alveolar arteries were verify as a common trunk in 27 cases (45.00%). The dehiscence of the posterior wall of the maxillary sinus, produced by the infraorbital artery was observed in 1 case (1.66%). In 53 cases (88.33%) the maxillary artery bifurcated in sphenopalatine and descending palatine branches, while in 7 cases (11.66%) was present the trifurcation. The sphenopalatine bifurcation in septal and posterior lateral nasal arteries inside the fossa was found in 54 cases (90.00%), and the ramification of the descending palatine artery in lesser palatine branches before of the penetration in the respectives canals, was present in all the cases.

Adult↗
PubMed1999

Anatomic, radiographic and physiologic comparisons of the internal carotid and maxillary artery in the horse.

The anatomy of the internal carotid and maxillary arteries was examined using angiography, subtraction angiography and arterial cast preparations in three horses. Subtraction angiography was superior to angiography in demonstrating the anatomy of the occipital, external ophthalmic, ethmoidal and palatine arteries. In three horses manipulation of the internal carotid and occipital arteries during angiography resulted in vasospasm which prevented filling of these vessels with contrast. Direct arterial blood pressure measurements of the maxillary artery impinging on the guttural pouches was measured in four anaesthetized and standing horses. Arterial pressure recordings from the maxillary artery indicate there is retrograde blood flow from contralateral vessels into the occluded arterial segment. Vasospasm prevented measurement of arterial pressure in the internal carotid artery.

Angiography↗
PubMedDate not supplied

Angiographic anatomy of the first and second segments of the maxillary artery.

The increasing use of interventional angiography makes it important to know the anatomy of the maxillary artery. The course and ramification pattern of the first and second segments of this artery were studied angiographically in 100 cases. The branches of the maxillary artery were identified on lateral stereoscopic images. The maxillary artery has three segments divided by the external pterygoid muscle, and the second of these segments divides into superficial and deep types. Of the 100 Japanese angiograms, 93% were of the superficial type and 7% of the deep type. The 93% was a much higher incidence than in Western populations. In the superficial types, the middle deep temporal artery and inferior alveolar artery arose separately from the maxillary artery, while in the deep types, they had a common trunk. This made it easy to differentiate the two types. The maxillary artery was classified into four subgroups (Ia, Ib, IIa and IIb) by the ramification patterns of the middle meningeal and accessory meningeal arteries from the first segment.

Angiography, Digital Subtraction↗
PubMed1999

Balloon compression of the intramaxillary sinus for intractable post-traumatic bleeding from the maxillary artery. Case report.

We present a case of severe intractable epistaxis after midfacial trauma in which the bleeding was identified as coming from the descending palatine artery, a branch of the maxillary artery. It could not be controlled by simple packing, and was stopped by inserting a balloon into the maxillary sinus, tamponading the injured vessel in the sphenopalatine fossa (pterigopalatine fossa). We describe an easy and practical emergency manoeuvre to control bleeding from inaccessible branches of the maxillary artery and to prevent rebleeding after embolisation.

Adult↗
PubMed1976

[Maxillary artery to middle cerebral artery anastomosis in dog-- a new experimental model (author's transl)].

End-to-side anastomosis between the maxillary artery and a branch of the middle cerebral artery was performed in the dog. The technique was devised as a new experimental model for extracranial-intracranial arterial shunt operation. The middle cerebral artery was ligated at the origin through a subtemporal small burr hole under the operating microscope in 13 dogs. Then, the shunt operation was carried out in 8 dogs 4 hours after the ligation(acute state), and in 5 dogs 3 weeks after(chronic stage). The patency of the anastomotic site was evaluated by the selective external carotid angiography 2 weeks after the shunt operation. In the acute stage of 8 dogs, 7 cases showed patency of anastomosis (88%), and in the chronic stage of 5 dogs, arteriogram revealed 4 patent anastomosis (80%). In successful cases, arteriogram showed excellent filling of the entire territory of the middle cerebral artery through the shunts (Fig. 4, 5). Various types of experimental shunt operation were attempted in our review of the literature. Among them, the anastomosis between the superficial temporal artery and a branch of the middle cerebral artery by Yasargil (1967) is rather popular and this procedure has been used by some investigators including us to investigate the effect of the extracranial-intracranial shunt on experimental acute stroke. So far as dog's experiment is concerned, the superficial temporal artery appeared to be not suitable for a donor artery, because the superficial temporal artery runs far from the middle cerebral artery and its distal part is extremely small in caliber. Therefore, the superficial temporal artery was often obstructed by compression, kinking or narrowing by surrounding tissues and by adhesion to the bone edge of the burr hole. On the other hand, the maxillary artery of the dog, which is the largest terminal branch of the external carotid artery, has plenty of blood flow and suitable size for end-to-side anastomosis to the middle cerebral artery. In addition, maxillary artery is located very close to the proximal part of the middle cerebral artery. These anatomical and spatial advantage of the maxillary artery seemed to be favorable donor artery to the middle cerebral artery and have brought hight patency rate in our series of anastomosis than that of the other previous experimental extracranial-intracranial shunts. To our knowledge, this is the first report on successful patent shunt formation after long-term occlusion of the middle cerebral artery in animals. Now, it is in our mind that progress of the study can be expected in the field of extracranial-intracranial shunt operation for cerebral infarction by this experimental procedure.

Animals↗
PubMed1987

Haemorrhage from the maxillary artery. A case report.

Haemorrhage from the maxillary artery can be life-threatening. The literature related to ligation of the external carotid artery at various levels to control such haemorrhage is reviewed and a case presented where a severe haemorrhage from the maxillary artery was controlled by ligation of the external carotid artery distal to the posterior auricular/occipital trunk.

Adult↗