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Clinical Note |

Mycotic Pseudoaneurysm of the Internal Maxillary Artery Case Report and Review of the Literature

Gavin P. Dunn, MD, PhD; Ravindra Uppaluri, MD, PhD; Jill L. Hessler, MD; Michael K. Layland, MD; Colin P. Derdeyn, MD; John B. Sunwoo, MD
Arch Otolaryngol Head Neck Surg. 2007;133(4):402-406. doi:10.1001/archotol.133.4.402.
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Pseudoaneurysms of the internal maxillary artery are rare entities that are most commonly caused by trauma. Herein we report a novel case of an internal maxillary artery pseudoaneurysm of infectious etiology and discuss the diagnosis and treatment of this disease.

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Figure 1.

Axial source image from the helical computed tomographic examination of the neck demonstrating the bilobed enhancing mass located in the parotid and masticator spaces. The mass is anterior to the styloid process (black arrowhead). The white arrowheads mark the limits of the mass. Unopacified thrombus surrounds the 2 enhancing lobes (black asterisks) of the pseudoaneurysm. The internal maxillary artery (white arrow) courses posteriorly behind the aneurysm prior to entering it more superiorly (not shown).

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Figure 2.

Three-dimensional computed tomographic reconstruction of the neck demonstrating the bony and vascular anatomy. The view is from the left lateral side of the neck and slightly posteriorly. The internal maxillary artery (IMax) courses superiorly to bifurcate into the 2 lobes of the pseudoaneurysm (PsA). A deep temporal branch continues on beyond the aneurysms. Also seen to good advantage are the mandible (M), the internal carotid artery (Ca), the vertebral artery (Va), the jugular vein (J), and the occipital artery (Occ).

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Figure 3.

Intraoperative view of left internal maxillary pseudoaneurysm resection showing pseudoaneurysm (A), left external carotid artery (B), upper (C) and lower (D) divisions of cranial nerve VII and cranial nerve XII (E). Orientation: left = anterior, top = cranial.

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