Direct carotid cavernous fistula after submucous resection of the nasal septum

A carotid cavernous fistula (CCF) is an abnormal arteriovenous anastomosis between the carotid artery and the cavernous sinus. Etiologies of this cond ition reported in the literature so far include facial trauma, rupture of a n intracavernous aneurysm of the carotid artery, Ehler-Danlos syndrome and fibromuscular dysplasia of the cerebral arteries. Such fistulae were report ed as complications of rhinoplasty, transsphenoidal surgery, embolization o f cavernous sinus meningioma, and rhinocerebral mucormycosis. CCF may also occur spontaneously in children or as a congenital malformation. However, t o our knowledge, submucous resection of the nasal septum has not been repor ted before to ca use direct carotid-cavernous fistula. CT and angiographic findings are presented and a review of the literature for reported causes o f CCF is made as well as a brief discussion of the possible pathophysiology . Copyright (C) 2000 S. Karger AG, Basel.