Severe late-onset epistaxis following le Fort I osteotomy: angiographic localization and embolization

1988 ◽  
Vol 102 (3) ◽  
pp. 260-263 ◽  
Author(s):  
Neil B. Solomons ◽  
Ray Blumgart
Keyword(s):  
Late Onset ◽  
Maxillofacial Surgery ◽  
Severe Trauma ◽  
Maxillofacial Trauma ◽  
Maxillary Artery ◽  
Internal Maxillary Artery ◽  
Le Fort I Osteotomy ◽  
Artery Ligation ◽  
Le Fort ◽  
Le Fort I

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.

scholarly journals Life-threatening, delayed epistaxis after Le Fort I osteotomy: a case report

2021 ◽  
Author(s):  
Amir Eleuch ◽  
Maha Ben Rejeb ◽  
Anis Ayadi ◽  
Samia Ayachi ◽  
Ramzi Moatemri ◽  
...  
Keyword(s):  
Case Report ◽  
Maxillary Artery ◽  
Internal Maxillary Artery ◽  
Le Fort I Osteotomy ◽  
Case Presentation ◽  
Le Fort ◽  
Operative Complication ◽  
Life Threatening ◽  
The Right ◽  
Le Fort I

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.

scholarly journals Le Fort I osteotomy facilitated nasotracheal intubation in a patient with concha bullosa and septal deviation: a case report

2021 ◽  
Keyword(s):  
Case Report ◽  
Nasal Cavity ◽  
Orthognathic Surgery ◽  
Nasotracheal Intubation ◽  
Maxillofacial Surgery ◽  
Septal Deviation ◽  
Concha Bullosa ◽  
Le Fort I Osteotomy ◽  
Le Fort ◽  
Le Fort I

Introduction: Nasotracheal intubation (NTI) is preferred for general anesthesia in maxillofacial surgery. However, NTI is often traumatic or even unsuccessful, particularly in patients with a narrow nasal pathway. In this case report, we describe a less traumatic NTI approach using maxillary downfracture of Le Fort I osteotomy. Case presentation: A 19-year-old woman was admitted with a skeletal Class III malocclusion and scheduled to undergo bimaxillary orthognathic surgery. A preoperative evaluation revealed no other medical history and abnormal laboratory findings. Preoperative computed tomography showed nasal septal deviation, concha bullosa, and turbinate hypertrophy. A nasal Ring-Adair-Elwyn endotracheal tube and a tube exchanger could not be inserted via NTI because of her narrow nasal cavity. An oral intubation was performed temporarily and surgery was started. After a maxillary downfracture was performed, which made the nasal cavity wider than before, NTI was successfully conducted without difficulty. The patient was ventilated without any problems, and the operation was continued. Postoperatively, the patient had no further complications and her vital parameters were all stable. Conclusions: This case report suggests that NTI after maxillary downfracture of Le Fort I osteotomy can be a good alternative that can be successfully performed with less trauma in patients undergoing orthognathic surgery who are preoperatively evaluated as having a narrow nasal cavity.

A Pilot Study Assessing the Incidence of Chronic Sinusitis Following Le Fort I Osteotomy in Maxillofacial Surgery

2019 ◽  
Vol 30 (6) ◽  
pp. 1845-1849
Author(s):  
Michael J. Eliason ◽  
Gregory Capra ◽  
Austin LaBanc ◽  
Jeanelle Braxton ◽  
Erin Hamersley ◽  
...  
Keyword(s):  
Pilot Study ◽  
Chronic Sinusitis ◽  
Maxillofacial Surgery ◽  
Le Fort I Osteotomy ◽  
Le Fort ◽  
Le Fort I

Maxillary Artery Pseudoaneurysm After Le Fort I Osteotomy

2010 ◽  
Vol 21 (4) ◽  
pp. 1079-1081 ◽  
Author(s):  
Kyle J. Chepla ◽  
Ali Totonchi ◽  
Daniel P. Hsu ◽  
Arun K. Gosain
Keyword(s):  
Maxillary Artery ◽  
Le Fort I Osteotomy ◽  
Artery Pseudoaneurysm ◽  
Le Fort ◽  
Le Fort I

scholarly journals Modified Le Fort I Osteotomy and Genioplasty for Management of Severe Dentofacial Deformity in β-Thalassaemia Major: Case report and review of the literature

2020 ◽  
Vol 20 (3) ◽  
pp. 362
Author(s):  
Khamis M. Al Hasani ◽  
Abdulaziz A. Bakathir ◽  
Ahmed K. Al-Hashmi ◽  
Badar Al Rawahi ◽  
Abdullah Albakri
Keyword(s):  
Case Report ◽  
Maxillofacial Surgery ◽  
Severe Anaemia ◽  
University Hospital ◽  
Thalassaemia Major ◽  
Le Fort I Osteotomy ◽  
Skeletal Deformity ◽  
Le Fort ◽  
Dentofacial Deformities ◽  
Le Fort I

β-thalassaemia major is an autosomal recessive form of haemoglobinopathy that is characterised by complete lack of production of the β-chains resulting in multiple complications that include severe anaemia, failure to thrive and skeletal abnormalities. Facial deformities induced by β-thalassaemia major are rare and are very challenging to treat from a surgical point of view. We report a 33-year-old female patient with β-thalassaemia major who presented to the Dental & Maxillofacial Surgery Department, Sultan Qaboos University Hospital, Muscat, Oman, in 2017 with gross dentofacial skeletal deformity contributing to her psychosocial issues. The facial deformity was corrected surgically by excision of the enlarged maxilla, modified Le Fort I osteotomy and advancement genioplasty. This case highlights the pre-operative preparation, surgical management, encountered complications and treatment outcome within 24 months of follow-up.Keywords: Beta-Thalassaemia; Thalassaemia Major; Cooley's Anemia; Le Fort Osteotomy; Genioplasty; Dentofacial Deformities; Case Report; Oman.

An arteriovenous fistula of the maxillary artery as a complication of Le Fort I osteotomy

2010 ◽  
Vol 38 (4) ◽  
pp. 251-254 ◽  
Author(s):  
Laetitia Goffinet ◽  
Boris Laure ◽  
Talel Tayeb ◽  
Defne Amado ◽  
Denis Herbreteau ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Maxillary Artery ◽  
Le Fort I Osteotomy ◽  
Le Fort ◽  
Le Fort I

scholarly journals An atypical case of trigeminal trophic syndrome: A legal medicine perspective in medical responsibility

2017 ◽  
Vol 5 ◽  
pp. 2050313X1772354
Author(s):  
Alessandro di Luca ◽  
Massimo Ralli ◽  
Sara Hemied ◽  
Marco de Vincentiis ◽  
Natale Mario di Luca
Keyword(s):  
Trigeminal Nerve ◽  
Rare Complication ◽  
Maxillofacial Surgery ◽  
Previous History ◽  
Class Iii ◽  
Le Fort I Osteotomy ◽  
Le Fort ◽  
Medical Responsibility ◽  
Trigeminal Trophic Syndrome ◽  
Le Fort I

Background: Trigeminal trophic syndrome is a rare complication of peripheral or central damage to the trigeminal nerve characterized by anesthesia, paresthesia and a secondary persistent facial ulceration. Methods: We describe the case of a 40-year-old woman with previous history of Le Fort I osteotomy for a class III malocclusion who developed trigeminal trophic syndrome. Atypically, the cutaneous symptoms appeared bilaterally and 8 years after surgery. Results: Differential diagnosis was based on clinical history, tissue biopsy and serologic evaluation. Atypical findings could be linked to the surgical burdens of Le Fort I osteotomy, a procedure characterized by a bilateral incision on the maxillofacial bones with a reasonable probability of causing a bilateral injury of the peripheral branches of the trigeminal nerve. Conclusion: Although the long delay between trigeminal trophic syndrome onset and surgery and the absence of adequate medical evidence cannot confirm a link with previous surgery in this case, the increasing number of maxillofacial surgery cases suggests that this complication may be more frequent in the next decades, and thus, involved specialists should be aware of this condition as a possible complication of maxillofacial surgery procedures.

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