Pseudoaneurysm of the superficial temporal artery is an unusual complication. Diagnosis is based on clinical findings and radiologic study. The standard treatment is surgical ligation and resection, and other treatment options include radiologic intervention, thrombin injection, and conservative treatment. In this article, the authors report several cases of pseudoaneurysm and suggest a treatment protocol to manage pseudoaneurysm of the superficial temporal artery.We conducted a retrospective review of 11 patients who underwent treatment of superficial temporal artery pseudoaneurysm between April 2002 and July 2011. According to the duration of the aneurysm, we divided the superficial temporal artery pseudoaneurysms into 3 stages: "Acute" stage is less than 3 weeks, "Subacute" stage is from 3 weeks to 3 months, and "Chronic" stage is more than 3 months.Among the 11 patients who were diagnosed with superficial temporal artery pseudoaneurysms, 7 cases were treated by surgical resection, 2 cases by conservative treatment, 2 cases by thrombin injection, and 1 case by radiologic intervention. There was no recurrence during the follow-up periods.The most successful standard treatment is surgical resection. More recently, many nonsurgical treatments have been used, such as conservative treatment, thrombin injection, endovascular embolization, or coiling. Every method has its advantages and disadvantages and should be chosen according to the chronicity and size of the pseudoaneurysm, patient's clinical status, including hemodynamic stability, patient's aesthetic preferences, and compliance. The authors suggest a systematic treatment protocol depending on the stage of the pseudoaneurysm, patients' status, and preferences.
Although pulsatile tinnitus can be audible, objective demonstration of this heartbeat-synchronous sound has rarely been successful. We report a rare case of pulsatile tinnitus in a 44-yr-old female patient, which was induced by a large mastoid emissary vein (MEV) and objectively documented by Doppler sonography of the left posterior auricular region. The tinnitus was intermittent and the patient could adapt to the tinnitus without intervention on the mastoid emissary vein. These findings suggest that a single large MEV can cause pulsatile tinnitus in the absence of other vascular abnormalities, and imaging studies of the posterior fossa and Doppler ultrasonography can aid the diagnosis in such cases.
Intravascular papillary endothelial hyperplasia is an uncommon benign vascular lesion characterized by a reactive proliferation of endothelial cells. The lesion of the finger often presents diagnostic challenges to surgeons because of its rarity. We report a case of intravascular papillary endothelial hyperplasia to facilitate the recognition of this uncommon lesion.
Deepening of the nasolabial crease is an esthetically unpleasing aging phenomenon occurring in the midface. Various treatment modalities have been introduced to improve the appearance of prominent nasolabial folds, all of which have pros and cons. Currently, a minimally invasive technique using synthetic dermal fillers is most commonly used. A simple and easy subcision procedure using a wire scalpel has also been used and reported to be effective for prominent nasolabial fold correction, with minimal complications. As an alternative to the wire scalpel, we used a 20-gauge metal type spinal needle cannula (Hakko Co.) and 4-0 Vicryl suture (Ethicon Inc.) for subcision of nasolabial folds. This technique is less expensive than the use of a wire scalpel and easily available when needed. Therefore, on the basis of favorable results, our modified subcision technique may be considered effective for prominent nasolabial fold correction.
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