微創顴骨整形手術術後之少見併發症大片硬膜外血腫－個案報告及文獻回顧

Huge epidural hematoma caused by re-duction malarplasty - a case report and review of literature

顴骨整形手術是一個對亞洲人來說最常見針對面部輪廓調整的策略。我們報告一個二十三歲的女性病患在接受經口腔微創顴骨整形手術後發生突發性意識喪失。腦部電腦斷層顯示左側大範圍硬膜外出血併中線偏移。在接受緊急開顱血塊清除減壓手術後病人有臨床上的實質上進步。因顴骨整形手術術中傷害到中腦膜動脈而造成的急性硬膜外出血為危及生命嚴重併發症，外科醫師應該要注意此併發症之可能性。然而，因術中傷害到中腦膜動脈而造成危及生命的硬膜外出血之併發症，在文獻中仍未被提出過。

 

Reduction malarplasty is considered as one of the most common strategies for fa-cial contouring for Asian patients. A 23-year-old female patient presented with sudden onset of consciousness disturbance after reduction malarplasty through the intraoral approach. Brain computed tomography (CT) revealed a left temporal epidural hematoma (EDH) with severe midline shift. Emergent craniectomy with hematoma evacuation was performed smoothly. The patient demonstrated substantial clinical improvement after the operation. Epidural hematoma resulting from injury to the middle meningeal artery is a rare but life-threatening complication of reduction malarplasty, and surgeons should be cautious about the possibility of this complication. Moreover, to the best of our knowledge, temporal EDH caused by injury to the MMA as a complication in reduction malarplasty has not pre-viously been reported.