Por causa da sua localização os pseudoaneurismas da artéria esfenoplatina (PAS) são extremamente raros. Sua formação é a partir de uma ruptura parcial do endotélio, resultando em vazamento de sangue nos tecidos circundantes. Aqui, relatamos este caso de PAS após agressão a face por projétil de arma de fogo, seguido de epistaxe incontrolável. É importante que os profissionais estejam cientes dessa complicação incomum do trauma facial e das alternativas para o tratamento dos pseudoaneurismas. A embolização fornece um método seguro e eficaz para o tratamento dessas lesões vasculares.

O seio maxilar define-se por um espaço pneumático na maxila bilateralmente que possui volume e proximidade com os ápices de 2º pré-molares e molares superiores, possibilitando que intervenções nestes afetem sua integridade, levando a inflamação e podendo resultar em Rinossinusite Crônica (RSC). Este estudo visa elucidar a atribuição da cirurgia endoscópica para tratamento da RSC através de um relato de caso clínico. Paciente sexo masculino, 50 anos, compareceu ao serviço de CTBMF do Hospital da Restauração-PE, com algesia em região zigomático-maxilar direita e comunicação oroantral, há sete meses, por exodontia traumática do elemento 15, já submetido à terapêuticas clínicas, sem sucesso. Diagnosticou-se ao exame físico e de imagem, RSC secundária, optando pela sinusectomia via endoscópica ântero-posterior acessando o seio maxilar direito por antrostomia maxilar na parede nasal lateral, removendo a mucosa doente e instalando um dreno de manutenção. Concomitantemente, fechou-se a comunicação bucossinusal por um retalho na mucosa vestibular maxilar recobrindo toda falha, sob anestesia geral. No pós-operatório imediato, iniciouse antibioticoterapia, analgesia e irrigação com soro fisiológico 0,9%, pelo dreno, removido após 72 horas. A cirurgia endoscópica como tratamento da RSC mostra-se uma alternativa quando há falha terapêutica clínica, apresentando melhora da sintomatologia e qualidade de vida dos pacientes.

The present study aims to develop an integrative review about pseudoaneurysms after traumatic facial trauma, through the analysis of its etiology, type of fracture, signs and symptoms, time elapsed between the trauma and the exposure of signs and symptoms, and treatment performed in these cases. Furthermore into the report, there are 3 clinical cases that occurred in the Buccomaxillofacial Surgery and Traumatology service of Hospital da Restauração Recife/PE. The study was carried out in 2 phases, first, a digital research about post-traumatic craniofacial pseudoaneurysm was performed in the following databases “MEDLINE/PubMed,” “Scielo” and “Scopus,” in September 2019, with 5 articles being included. In the second, 3 cases of patients with high-impact facial trauma who developed pseudoaneurysm of the internal carotid artery were reported. The average age of the patients was 35.6 years, all patients were male (100%), the majority (60%) being victims of an automobile accident, 3 patients (60%) suffered craniofacial trauma and 2 (40%) had trauma only to the face, most of them had symptoms later on due to the trauma, in 80% of cases the therapy instituted was embolization. Cases of high-impact craniofacial traumas, which present epistaxis and/or ophthalmological alterations correlated to fractures, should be carefully evaluated, determining a better prognosis for the patient.

Seroma cervical como sequela do trauma cérvico-facial penetranteCervical seroma as a sequel of penetrating cervic-facial trauma

Introduction: Ameloblastoma is a benign neoplasm characterized by the proliferation of odontogenic epithelium that mainly affects the gnathic bones and, due to its invasive and expansive growth, presents high rates of recurrence to surgical treatment. Among the most conservative treatments are enucleation and marsupialization; among radicals, resections are more widespread. Objective: The objective is to present, through a case report, conservative surgical treatment with enucleation followed by the use of the Carnoy solution. Case report: A 24-year-old male patient arrives at the outpatient clinic of Hospital da Restauração with painful complaints of mild and constant intensity in the region of the left mandibular angle, with an evolution of three weeks. After a panoramic X-ray, the presence of the included 38 tooth was associated with an extensive unilocular radiolucent lesion, surrounding the angle and mandibular ramus. Preoperative examinations were performed for incisional biopsy. Histopathological diagnosis was unicystic ameloblastoma. In view of the histopathology obtained, we opted for enucleation of the lesion with concomitant use of direct Carnoy solution in the region of the lesion. Discussion: The choice of therapeutic behavior depends on the size, type of lesion, location and histopathology. After the surgical decision, a radiographic clinical follow-up is necessary to assess possible recurrences. Carnoy's solution is a cauterizing agent with moderate tissue penetration, rapid local fixation and hemostatic action, whose surgical use in cystic lesions has occurred since the beginning of the 20th century. Conclusion: Conservative treatment with the enucleation technique followed by complementary therapy using Carnoy's solution proved to be quite effective.