Abstract
Introduction: When performing a Le Fort 1 osteotomy, there is always a risk of injuring the internal maxillary artery or one of its branches. This diagnosis should be considered when confronted to recurrent or massive epistaxis following surgery.Case presentation: The authors present a case of a life-threatening, delayed and massive epistaxis caused by a ruptured pseudoaneuvrysm of the right sphenopalatine artery as a post-operative complication of a Le Fort I osteotomy successfully managed by anterior and posterior nasal packing.Conclusion: Despite its simplicity and attested reliability, Le Fort I osteotomy is not completely free of complications.
AbstractEpistaxis following maxillofacial trauma or maxillofacial surgery is uncommon. It usually occurs within 24 hours of the injury and can usually be controlled by packing. Rarely internal maxillary artery ligation is necessary and embolization has been used in some cases of severe trauma.We present a case of severe late-onset epistaxis following Le Fort I osteotomy. The diagnostic approach and treatment are discussed.
When occlusal alterations are not accompanied by paranasal deficiencies, mobilization of the maxilla via Le Fort I osteotomy should be made with a different design. In this preliminary report, a W-shaped osteotomy that doesn’t change the position of the maxillary bone surrounding the pyriform aperture was presented for the first time. Advantages and indications of this new procedure are discussed.
Life-threatening, delayed epistaxis after Le Fort I osteotomy: a case report