CASE REPORT Aneurysm of the Distal Facial Artery From a Penetrating Oral Prosthesis R. SHANE TUBBS, 1,2 * DAVID R. KELLY, 3 W. JERRY OAKES, 2 AND E. GEORGE SALTER 1 1 Department of Cell Biology, University of Alabama at Birmingham, Birmingham, Alabama 2 Pediatric Neurosurgery, Children’s Hospital, Birmingham, Alabama 3 Department of Pathology and Laboratory Medicine, Children’s Hospital, Birmingham, Alabama We report a 94-year-old male who died of pneumonia. During the routine dissection of the head and neck for a gross anatomy course at our institution a mass was noted in the region of the right cheek. Macroscopic and microscopic observation of this mass revealed an aneurysm of the facial artery. A traumatic defect was noted at the apex of the aneurysmal wall related to an intraoral prosthetic clasp that had penetrated the buccinator muscle. Traumatic aneurysms of the face have been caused by blunt trauma to the jaw with or without fracture, surgical manipulation around the teeth and jaw, and following missile injury. Some have described compression of neighboring structures such as cranial nerves and other blood vessels with resultant compromise. We believe our case to be the first report of a facial artery aneurysm in a cadaver and we are unaware of other reports from the literature describing the production of a facial artery aneurysm from a puncture of an intraoral prosthesis through the medially placed buccinator muscle. Although seemingly rare, health care professionals should make efforts to ensure that oral prostheses do not develop sharp or irregular edges that could potentially perforate the lateral oral cavity with potential perforation of the overlying vasculature. Clin. Anat. 18:527–529, 2005. V V C 2005 Wiley-Liss, Inc. Key words: trauma; face; injury; external carotid INTRODUCTION The external carotid branches are protected along most of their course by overlying soft tissue. Many branches of this vessel cross bony surfaces, however, and are more prone to injury. Some of these branches are susceptible to iatrogenic injury. Dilata- tion of arterial branches can be classified as false or true aneurysms. False aneurysms have a traumatic etiology and true aneurysms are weakened regions of a vessel that contain all tunics (Conner et al., 1998; Aljaro et al., 2001). False aneurysms of the face most frequently involve the superficial temporal artery (Conner et al., 1998) CASE REPORT We report a 94-year-old male who died of pneu- monia. During the routine dissection of the head and neck for a gross anatomy course at our institu- tion a mass was noted in the region of the right cheek. Further dissection showed that the mass was attached to the facial artery as it passed superficial to the buccinator muscle (Figs. 1,2). No other anoma- lies were noted in this specimen and the remaining vasculature of the head and neck including the intra- cranium was found to be normal. The mass (1.4 Â 1.1 Â 1.1 cm) and approximately 1.5 cm of the unin- volved facial artery both proximal and distal to the mass was removed and analyzed histologically. Microscopic observation of this mass showed an *Correspondence to: R. Shane Tubbs, PhD, Pediatric Neurosurgery, Children’s Hospital, 1600 7th Avenue South ACC 400, Birmingham, AL 35233. E-mail: rstubbs@uab.edu Received 21 June 2004; Revised 7 October 2004; Accepted 22 January 2005 Published online 13 July 2005 in Wiley InterScience (www. interscience.wiley.com). DOI 10.1002/ca.20137 V V C 2005 Wiley-Liss, Inc. Clinical Anatomy 18:527–529 (2005)