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Internal carotid dissection after Le Fort III distraction in Apert syndrome: a case report.

Abstract
A 10-year-old girl with Apert syndrome underwent a Le Fort III osteotomy with the positioning of internal and external distraction devices. The operation was straightforward with no intraoperative complications. Very soon after completion of surgery an anisocoria (unilateral dilation of a pupil) was noticed. This was followed by intracranial oedema which was fatal. The aetiology was dissection of the right internal carotid artery is reported. The complications of Le Fort osteotomies are discussed regarding patients with complex syndromal craniosynostosis and midface hypoplasia, such as Apert syndrome.
AuthorsErik Nout, Irene M J Mathijssen, Jacques J N M van der Meulen, Marie-Lise C van Veelen, Anton H J Koning, Maarten H Lequin, Eppo B Wolvius
JournalJournal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery (J Craniomaxillofac Surg) Vol. 38 Issue 7 Pg. 529-33 (Oct 2010) ISSN: 1878-4119 [Electronic] Scotland
PMID20303281 (Publication Type: Case Reports, Journal Article)
CopyrightCopyright © 2010 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
Topics
  • Acrocephalosyndactylia (surgery)
  • Brain Edema (etiology)
  • Carotid Artery, Internal, Dissection (complications, etiology)
  • Child
  • Fatal Outcome
  • Female
  • Humans
  • Osteogenesis, Distraction
  • Osteotomy, Le Fort (adverse effects, methods)

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