Arteriovenous fistula : Rare but serious complication of the temporomandibular joint arthroscopy

Background: Temporomandibular joint (TMJ) arthroscopy is a safe and minimally invasive procedure involving arthroscopic examination and operative surgery for joint arthrogenous disorders. Common complications of surgery include fluid extravasation, bleeding, and damage to the joint and associated structures. However, most of them are transient and easily controlled. Of the very rare complications is an arteriovenous fistula (AVF), which is an abnormal connection between an artery and a vein as a result of iatrogenic injury from TMJ arthroscopy. Case presentation We present a case of 52-year-old woman who presented with a whooshing sound, an audible bruit and a palpable thrill related left TMJ region after TMJ arthroscopy. The patient was suspected of vascular lesion and was diagnosed with an AVF involving a left transverse facial artery and superficial temporal vein by selective angiography. The patient underwent successful embolisation of the AVF under local anesthesia with intra-operative confirmation using angiography and clinical resolution of the symptoms. Conclusion: Due to its rarity, clinicians need to be aware of its presentation and the need for a multidisciplinary approach in order to provide timely and efficient treatment. To the best of our knowledge, we report the first case of AVM secondary to TMJ arthroscopy involving transverse facial artery and superficial temporal vein.