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.

Purpose: Major maxillary and facial tumor resections are often associated with substantial intraoperative blood loss due to rich vascular supply from branches of the external carotid artery (ECA). We present a case series of three selected patients undergoing extensive maxillofacial tumor resection in whom temporary proximal ECA restriction using a Rummel tourniquet was applied. Results: Estimated blood loss ranged from 550 to 1500 mL. No postoperative neurological deficits or delayed arterial hemorrhage were observed. Temporary proximal ECA restriction was technically feasible through cervical exposure and provided reversible arterial inflow modulation. Conclusions: Although limited by the small sample size and lack of comparative analysis, this case series suggests that temporary proximal ECA restriction using a Rummel tourniquet may serve as a practical adjunct in selected patients undergoing extensive maxillofacial tumor resection. Further studies are warranted to better define its clinical value.

External stapediovestibular dislocations are rare and often traumatic. Congenital facial nerve anomalies, as in this case, make reconstruction of the ossicular chain even more challenging. A 37-year-old woman patient presented progressive bilateral hearing loss and aural fullness for 1 month in May 2024. She had suffered a fall from a height of approximately 4 stories in 2017. The audiometry showed bilateral conductive hearing loss with an air-bone gap greater than 50 dB. A temporal bone computed tomography scan showed suspected stapes detachment and facial nerve anomalies in both ears. Right exploratory tympanotomy revealed external stapediovestibular dislocation with duplication of facial nerve in the tympanic segment. A type V tympanoplasty with piston wire insertion was performed. Audiometry after right ear surgery showed closure of the air-bone gap by 42 dB, without vertigo or facial nerve injury. Surgery aims to prevent facial nerve injury while successful restoring hearing loss. The cause of stapediovestibular dislocation is discussed, along with methods for reconstruction of the ossicular chain.