World J Oral Maxillofac Surg | Volume 1, Issue 1 | Case Report | Open Access
Constantinos Laskarides1* and Adel M. Malek2
1Department of Oral & Maxillofacial Surgery, Tufts University, USA
2Department of Neurosurgery, Tufts Medical Center, USA
*Correspondance to: Constantinos Laskarides
Fulltext PDFThe LeFort I osteotomy surgery is a well-established method of manipulating the position of the
maxilla in all three planes of space. It may be used alone or in combination with mandibular
surgery to aid in correction of dentofacial deformities. As with all surgery, orthognathic surgery
is not without risks and complications. Vascular injuries in LeFort I osteotomies are commonly
associated with damage of the Descending Palatine (DP) or Sphenopalatine Arteries (SPA) which
are in close approximation to the pterygomaxillary junction. This junction is separated to allow for
down fracture of the maxillae. In respect to orthognathic surgery to the maxillae, it has been long the
surgeon's concern for increased bleeding during LeFort osteotomy procedures.
An exceedingly rare complication from orthognathic surgery is traumatic aneurysm to the external
carotid and its attributaries. Vessel wall trauma leading to sub adventitial dissection (between the
tunica media and adventitia) results in the formation of aneurysmal dilatation of the vessel. Dissecting
psuedoaneurysm develops when the true arterial lumen communicates with the dissecting cavity.
The small caliber of the tributaries of the external carotid makes a pseudoaneurysm uncommon as
a complete transection of the vessel is more likely to occur. The surgical correction of the aneurysm
is indicated as soon as possible to decrease the risk of complications, including hemorrhage from
rupture, thrombosis, infection, or neurologic dysfunction caused by continued expansion. In
this case report we describe an unusual case of a pseudoaneurysm after LeFort I osteotomy, for
impaction and advancement of the maxilla.
Laskarides C, Malek AM. Pseudoaneurysm as a Complication of Orthognathic Surgery: A Case Report. World J Oral Maxillofac Surg. 2018;1(1): 1003..