Introduction: Over the past two decades, temporomandibular joint (TMJ) replacement with prosthetic devices has become an acceptable treatment for multiple conditions including: idiopathic condylar resorption, degenerative joint disease, ankyloses, among others. With the increase of the procedure, the incidents of other complications such as facial nerve damage, infections, and heterotopic bone formation around the prosthesis have increased. Another rare complication is the formation of an internal maxillary artery aneurysm (IMAA). There have been multiple cases of IMAA noted with facial traumas involving multiple fractures; however, with all of the joints being placed, the incidents of IMAA in the setting of TMJ surgery has not been studied or reported.

Methods: Case presentation of an internal maxillary artery aneurysm forming after a right TMJ arthroplasty and reconstruction with a Biomet stock prosthesis.

Results: The patient, after undergoing a right TMJ arthroplasty and reconstruction, was found to have a right IMAA and was treated with endovascular coiling. Complete aneurysm embolization was achieved without compromise to the distal vasculature with significant improvement of patient symptoms.

Conclusions: Internal maxillary artery aneurysms are rare complications seen mostly in post-traumatic patients and rarely seen in maxillofacial surgeries. The above case presents a patient who developed such a lesion after TMJ surgery with prosthesis placement, presenting a noteworthy complication of a procedure that has increasingly been performed over the past 20 years. Bringing into light the possibility of such a lesion will allow clinicians to be better equipped to recognize and appropriately treat this disease, continuing to support the paramount role an inter-disciplinary team plays in improving patient care.

Patient Care: By shedding light onto a very rare, and previously unreported complication of TMJ surgery, this presentation will allow clinicians to be better equipped in recognizing the disease and also promote the inter-disciplinary approach to patient care, showing the importance of careful discussion, communication, and coordination between different specialties.

Learning Objectives: By conclusion of this session, participants should be able to recognize the possibility of this rare complication of TMJ surgery and to better treat and manage such patients in an inter-disciplinary approach.

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