Document Detail

Massive repeated nose bleeding after bimaxillary osteotomy.
MedLine Citation:
PMID:  17993912     Owner:  NLM     Status:  MEDLINE    
In LeFort I surgery, the separation of the pterygomaxillary junction is done by osteotomy. Although the osteotome is positioned too close to the maxillary artery and its branches during pterygomaxillary separation, postoperative complications from vascular injuries are uncommon. We describe an unusual occurrence of a maxillary artery pseudoaneurysm after LeFort I and bilateral sagittal split osteotomies for maxillary advancement and mandibular setback as well as (anterior sliding) genioplasty. In a patient with class III occlusion and midface retrusion, the significant bleeding began 10 days postoperatively, which was controlled by anterior and posterior nasal packing. The bleeding recurred 28 days after surgery; thus, vascular anatomy in the pterygomaxillary area is reviewed, pseudoaneurysm was diagnosed on selective carotid angiography and successfully treated by embolization; and 2-year follow up was uneventful.
Ali Manafi; Hossein Ghenaati; Farideh Dezham; Mahnaz Arshad
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of craniofacial surgery     Volume:  18     ISSN:  1049-2275     ISO Abbreviation:  J Craniofac Surg     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-11-12     Completed Date:  2008-02-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010410     Medline TA:  J Craniofac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1491-3     Citation Subset:  D    
Department of Plastic Surgery, Iran University of Medical Sciences, Tehran, Iran.
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MeSH Terms
Aneurysm, False / complications,  etiology*
Chemoembolization, Therapeutic
Epistaxis / etiology*,  therapy
Malocclusion, Angle Class III / surgery*
Mandible / surgery
Maxillary Artery / injuries*
Osteotomy, Le Fort / adverse effects*

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