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Stab Injury to the Preauricular Region With Laceration of the External Carotid Artery Without Involvement of the Facial Nerve: a Case Report

dc.contributor.authorCasal, D
dc.contributor.authorPelliccia, G
dc.contributor.authorPais, D
dc.contributor.authorCarrola-Gomes, D
dc.contributor.authorAlmeida, MA
dc.contributor.authorVideira e Castro, J
dc.contributor.authorGoyri-O'Neill, J
dc.date.accessioned2017-11-03T16:04:09Z
dc.date.available2017-11-03T16:04:09Z
dc.date.issued2017-07-29
dc.description.abstractBACKGROUND: Open injuries to the face involving the external carotid artery are uncommon. These injuries are normally associated with laceration of the facial nerve because this nerve is more superficial than the external carotid artery. Hence, external carotid artery lesions are usually associated with facial nerve dysfunction. We present an unusual case report in which the patient had an injury to this artery with no facial nerve compromise. CASE PRESENTATION: A 25-year-old Portuguese man sustained a stab wound injury to his right preauricular region with a broken glass. Immediate profuse bleeding ensued. Provisory tamponade of the wound was achieved at the place of aggression by two off-duty doctors. He was initially transferred to a district hospital, where a large arterial bleeding was observed and a temporary compressive dressing was applied. Subsequently, the patient was transferred to a tertiary hospital. At admission in the emergency room, he presented a pulsating lesion in the right preauricular region and slight weakness in the territory of the inferior buccal branch of the facial nerve. The physical examination suggested an arterial lesion superficial to the facial nerve. However, in the operating theater, a section of the posterior and lateral flanks of the external carotid artery inside the parotid gland was identified. No lesion of the facial nerve was observed, and the external carotid artery was repaired. To better understand the anatomical rationale of this uncommon clinical case, we dissected the preauricular region of six cadavers previously injected with colored latex solutions in the vascular system. A small triangular space between the two main branches of division of the facial nerve in which the external carotid artery was not covered by the facial nerve was observed bilaterally in all cases. CONCLUSIONS: This clinical case illustrates that, in a preauricular wound, the external carotid artery can be injured without facial nerve damage. However, no similar description was found in the reviewed literature, which suggests that this must be a very rare occurrence. According to the dissection study performed, this is due to the existence of a triangular space between the cervicofacial and temporofacial nerve trunks in which the external carotid artery is not covered by the facial nerve or its branches.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJ Med Case Rep. 2017 Jul 29;11(1):205pt_PT
dc.identifier.doi10.1186/s13256-017-1361-9pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/2774
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherBioMed Centralpt_PT
dc.subjectCHLC CPRpt_PT
dc.subjectCarotid Artery Injuries/surgerypt_PT
dc.subjectCadaverpt_PT
dc.subjectCarotid Artery, External/anatomy & histologypt_PT
dc.subjectFacial Nerve/anatomy & histologypt_PT
dc.subjectLacerations/surgerypt_PT
dc.subjectNeck/diagnostic imagingpt_PT
dc.subjectTomography, X-Ray Computedpt_PT
dc.subjectTreatment Outcome
dc.subjectWounds, Stab/surgery
dc.titleStab Injury to the Preauricular Region With Laceration of the External Carotid Artery Without Involvement of the Facial Nerve: a Case Reportpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue1pt_PT
oaire.citation.startPage205pt_PT
oaire.citation.titleJournal of Medical Case Reportspt_PT
oaire.citation.volume11pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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