Tourniquet Restriction of External Carotid Artery vs. Internal Maxillary Artery Ligation for Bleeding Control in Total Maxillectomy

Background/Objectives: Temporary artery ligation or compression is commonly used to reduce intraoperative blood loss in various surgeries, including uterine procedures. In head and neck surgery, the external carotid artery (ECA) typically branches into eight vessels, supplying most of the head and neck except for the brain. Severe and uncontrolled bleeding can occur if these branches are inadvertently damaged during surgery. However, limited research exists on temporary arterial ligation during head and neck surgeries. This study aimed to evaluate the effects of temporary ECA restriction and internal maxillary artery (IMA) ligation on minimizing intraoperative blood loss during head and neck surgery. Methods: This study involved 25 patients with terminal-stage maxillary tumors who underwent total maxillectomy. The effectiveness of IMA ligation and ECA restriction using a Rummel tourniquet in controlling intraoperative bleeding was compared. Results: The average blood loss was significantly lower in the ECA restriction (467 mL) and IMA ligation (461 mL) groups than in the control group (794 mL). However, no significant difference was observed between the IMA ligation and ECA restriction methods. Conclusions: Overall, our results suggest that either method is effective; however, ECA restriction is preferred for tumors involving the infratemporal fossa.