Document Detail

Carotid cavernous sinus fistula caused by dental implant-associated infection.
MedLine Citation:
PMID:  21924520     Owner:  NLM     Status:  MEDLINE    
A 61-year-old woman presented with painful ophthalmoplegia, Tolosa-Hunt syndrome. The patient had undergone a placement of dental implant 5 months before the presentation and had a local maxillary sinusitis 1 month later. She had not been aware of any preceding head trauma or infection. On examination, the patient showed serious right oculomotor nerve paresis and retro-orbital pain. Blood examination showed normal findings. Magnetic resonance imaging identified abnormal structure in the right cavernous sinus with flow void signals. Angiography revealed a carotid cavernous sinus fistula fed by the intracavernous branches of the internal carotid artery on both sides, right internal maxillary and middle meningeal arteries, and left ascending pharyngeal artery. The patient underwent coil embolization via both external carotid arteries. We assumed that local maxillary sinusitis caused by dental implant might spread hematogenously into the sphenoid and cavernous sinuses and formed a carotid cavernous sinus fistula, which presented with Tolosa-Hunt syndrome. Implant-associated infection has to be managed promptly with adequate manner before it spreads.
Yuzaburo Shimizu; Satoshi Tsutsumi; Yukimasa Yasumoto; Masanori Ito
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2011-09-15
Journal Detail:
Title:  American journal of otolaryngology     Volume:  33     ISSN:  1532-818X     ISO Abbreviation:  Am J Otolaryngol     Publication Date:    2012 May-Jun
Date Detail:
Created Date:  2012-05-01     Completed Date:  2012-09-25     Revised Date:  2013-05-06    
Medline Journal Info:
Nlm Unique ID:  8000029     Medline TA:  Am J Otolaryngol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  352-5     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Department of Neurological Surgery, Juntendo University Urayasu Hospital, Chiba, Japan.
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MeSH Terms
Carotid-Cavernous Sinus Fistula / diagnosis,  etiology*,  therapy
Dental Implants / adverse effects*,  microbiology
Diagnosis, Differential
Embolization, Therapeutic
Follow-Up Studies
Magnetic Resonance Imaging
Middle Aged
Prosthesis-Related Infections / diagnosis,  etiology*
Tomography, X-Ray Computed
Reg. No./Substance:
0/Dental Implants

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