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A 67-year-old woman who had undergone rhytidectomy 5 years before her presentation experienced increasing pulsatile tinnitus on the left side that had begun 2 years earlier. Angiography revealed a direct arteriovenous fistula between the superficial temporal artery and superficial temporal vein in front of her left ear. There was a scar from the earlier cosmetic surgery at the site. The fistula was embolized with N-butyl cyanoacrylate, and her tinnitus disappeared. We posit that the fistula was a complication of rhytidectomy and that a small arteriovenous fistula formed at the time of surgery and enlarged over time. This case indicates that arteriovenous fistulae can occur as a delayed complication of cosmetic surgery.


Shushi Kominami, Akira Watanabe, Masahiro Akimoto, Shiro Kobayashi, Akira Teramoto. Superficial temporal arteriovenous fistula as a complication of rhytidectomy. The Journal of craniofacial surgery. 2012 Mar;23(2):603-5

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PMID: 22446426

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