Delayed presentation of pseudoaneurysm after Le Fort I osteotomy.

Abstract

Although the osteotome is positioned in close vicinity to the maxillary artery and its branches during ptergomaxillary separation in a Le Fort I osteotomy, postoperative complications from vascular injuries are rare. The following report describes an unusual occurrence of a maxillary artery pseudoaneurysm following a Le Fort I and bilateral sagittal-split osteotomies for correction of mandibular and maxillary asymmetries in a patient with Goldenhar syndrome. This was recognized 8 months after the procedure when the patient developed acute facial swelling and required an emergent angiogram for uncontrolled bleeding. Vascular anatomy in the ptergomaxillary area is reviewed. A level of suspicion of occult vascular injuries in patients with sudden onset of unilateral facial swelling after orthognathic surgery, even months after the procedure, is recommended.

• Authors: James P Bradley, Mohammed Elahi, Henry K Kawamoto
• Journal: The Journal of craniofacial surgery (J Craniofac Surg) Vol. 13 Issue 6 Pg. 746-50 (Nov 2002) ISSN: 1049-2275 [Print] United States
• PMID: 12457086 (Publication Type: Case Reports, Journal Article)

Topics

• Adolescent
• Aneurysm, False (etiology, therapy)
• Embolization, Therapeutic (instrumentation)
• Facial Asymmetry (etiology, surgery)
• Goldenhar Syndrome (complications)
• Humans
• Male
• Mandible (surgery)
• Maxillary Artery (injuries)
• Osteotomy, Le Fort (adverse effects)