Objective: To report a successfully healed case of carotid cavernous fistula with life threatening epistaxis by intravascular embolism and muscle paste plugging in sphenoid sinus.
Method: The patient was found a tumor in sella turcica by imaging, invading into cavernous sinus and sphenoid sinus. During operation,the internal carotid artery was ruptured, and two times of life-threatening apistaxis were happened. The digital subtraction angiography and intravascular embolism were carried out two times, then, muscle paste was plugged into sphenoid sinus via nasal endoscopy.
Result: The patient was successfully healed. And a flowing up of 8 months showed that epistaxis did not occur again and muscle paste was survival in sphenoid sinus.
Conclusion: After emergent managements such as nasal plugging and transfusion for epistaxis caused by carotid cavernous fistula, the intravascular embolism, muscle paste plugging in sphenoid sinus under transnasal endoscopic surgery were an available and effective management.