A Case of a Huge Facial Hematoma During Endoscopic Sinus Surgery

The posterior superior alveolar artery (PSAA) is a branch of the maxillary artery that supplies blood to the lateral wall of the sinus and the overlying membrane. It is located in the lateroposterior wall of the maxillary sinus and is almost intra-osseous, making surgeries there challenging for the risk of injury during routine endoscopic sinus surgery (ESS). Indeed, there is approximately 20% risk of damage in situations such as Le Fort I fracture surgery, maxillary sinus expansion, removal of lesions and inflammation in the maxillary sinus, surgical procedures involving orthognathic surgery and dental implant treatment, as well as in occurrences of fractures and fenestration during surgery, potentially leading to significant bleeding. We present a rare case of facial hematoma due to PASS injury following ESS, with subsequent improvement and no additional complications after treatment.