[Severe vascular complications of Le Fort I osteotomy]

Rev Stomatol Chir Maxillofac. 2012 Feb;113(1):14-8. doi: 10.1016/j.stomax.2011.10.003. Epub 2011 Nov 10.
[Article in French]

Abstract

Introduction: Le Fort I osteotomy is a common orthognathic procedure. This surgery presents risk of severe vascular complications because of local anatomy. The aim of our study was to collect data on vascular complications of Le Fort I osteotomies performed in our department, describe the diagnostic and therapeutic aspects, and discuss prevention.

Patients and methods: A retrospective analysis was made on the files of patient having undergone Le Fort 1 osteotomy, between 1998 and 2007. Severe vascular complications were recorded, defined as postoperative hemorrhagic or ischemic complications severe enough to require a specific procedure.

Results: Nine hundred and sixteen patient files were included (39% male and 61% female patients, mean-age: 24.42 years; range: 13 to 59 years). Five patients presented with severe hemorrhagic complication. There was no ischemic complication. Three hemorrhagic episodes occurred in the immediate postoperative phase. In two cases, delayed hemorrhagic complication occurred, diagnosed as a pseudo-aneurysm by angiography. These were treated by hyperselective embolization.

Discussion: Vascular complications of Le Fort I osteotomies are rare (0.55% in our series). They are most frequently hemorrhagic complications.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Humans
  • Male
  • Maxilla / surgery*
  • Middle Aged
  • Osteotomy, Le Fort / adverse effects*
  • Osteotomy, Le Fort / statistics & numerical data
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control
  • Retrospective Studies
  • Severity of Illness Index
  • Vascular Diseases / epidemiology
  • Vascular Diseases / etiology*
  • Young Adult