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Ligation of an unusually large vessel during maxillary sinus floor augmentation. A case report.

PURPOSE
The purpose of the present case report was to document a maxillary sinus floor augmentation procedure involving ligation of a blood vessel with a nearly 3-mm diameter in the lateral wall of the maxillary sinus.


MATERIALS AND METHODS
A bilateral maxillary sinus floor augmentation procedure was performed in a 51-year-old healthy man. The preoperative computed tomography scan revealed a bony canal within the lateral maxillary sinus wall of the right as well as the left side close to the alveolar ridge.


RESULTS
A vessel with a diameter of nearly 3 mm was identified during the sinus floor augmentation on the left side. The vessel was exposed and ligated. A vessel with a diameter of approximately 1 mm was identified on the right side and the sinus floor augmentation was performed without ligation. No complications were observed and the postoperative healing was uneventful.


CONCLUSIONS
Although accidental laceration of vessels with an unusually large diameter during maxillary sinus floor augmentation is not life-threatening, impaired visualisation may compromise the augmentation procedure, including the elevation of the Schneiderian membrane. Moreover, postoperative bleeding and formation of a haematoma may occur. Therefore, ligation of vessels with an unusually large diameter is recommended during maxillary sinus floor augmentation to minimise intra- and postoperative complications.