Major vascular complications of orthognathic surgery: Hemorrhage associated with Le Fort I osteotomies

Lanigan, Dennis T.; Hey, Juliana H.; West, Roger A.

doi:10.1016/s0278-2391(10)80468-9

Cited by 175 publications

(83 citation statements)

References 22 publications

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“…The internal maxillary artery and their branches i.e. sphenopalatine artery and ascending palatine artery are most vulnerable to damage in their course through pterygopalatine fossa [13]. Use of right angled saw to separate the maxilla from pterygoid plates has been proposed by Lanigan and Guest to improve the safety of dysjunction [14].…”

Section: Vascular Complicationsmentioning

confidence: 99%

Evaluation of Post-operative Complication Rate of Le Fort I Osteotomy: A Retrospective and Prospective Study

Garg

Kaur

2012

J. Maxillofac. Oral Surg.

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Le Fort I osteotomy has become a routine procedure in elective orthognathic surgery. This procedure is often associated with significant but rare post-operative complications. The study was conducted to evaluate the rate of post-operative complications following conventional Le Fort I osteotomy. Twenty-five healthy adult patients who had to undergo Le Fort I osteotomy without segmentalization of maxilla were included in the study based on indications of surgery. All the patients were followed up for a period of 6 months post-operatively to assess the rate of various post-operative complications such as neurosensory deficit, pulpal sensibility, maxillary sinusitis, vascular complications, aseptic necrosis, unfavourable fractures, ophthalmic complications and instability or non-union of maxilla, etc. The results of our study showed a post-operative complications rate of 4 %. Neurosensory deficit and loss of tooth sensibility were the most common findings during patient evaluation at varying follow-up periods while one patient presented with signs and symptoms of maxillary sinusitis post-operatively. Neurosensory as well as sinusitis recovery took place in almost all the patients within 6 months. It was concluded that thorough understanding of pathophysiological aspects of various complications, careful assessment, treatment planning and the use of proper surgical technique as well as instrumentation may help in further reducing the complication rate.

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Section: Vascular Complicationsmentioning

confidence: 99%

Evaluation of Post-operative Complication Rate of Le Fort I Osteotomy: A Retrospective and Prospective Study

Garg

Kaur

2012

J. Maxillofac. Oral Surg.

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“…Maxillofacial surgical procedures, such as orthognathic surgery, may be associated with significant blood loss and, infrequently, lifethreatening hemorrhage caused by injury to the vascular structures in the pterygopalatine fossa, such as the pterygoid venous plexus, the descending palatine arteries, the sphenopalatine arteries, or the maxillary artery itself, leading to acute epistaxis. 18 Pooled data revealed that in 72% of the Le Fort osteotomies, an arterial source was the culprit, whereas in almost 19% of the cases, the source of hemorrhage was venous. In the remaining cases, the exact source was unidentifiable.…”

Section: Discussionmentioning

confidence: 99%

Acute Bleeding in the Head and Neck: Angiographic Findings and Endovascular Management

Zhang

Shi

Park

et al. 2013

American Journal of Neuroradiology

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“…was 7 days. Surgical complications described in literature include excessive bleeding, maxillary nerve branch injury, infection, pain, devitalization of upper teeth, gingival recession, recurrence, and unilateral expansion 4,9,10 . Complications may increase due to the device used, including breakage or loss of the device, breakage or locking of the fastener, and excessive force over the mucosa leading to necrosis 10,11 .…”

Section: Discussionmentioning

confidence: 99%

Expansão rápida da maxila cirurgicamente assistida: estudo preliminar

Vasconcelos¹,

Caubi²,

Dias³

et al. 2006

Rev. Bras. Otorrinolaringol.

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Surgi cally assisted rapid maxillary expansion is efficient for the treatment of transverse maxillary deficiencies in skeletally mature patients. Aim: To study two techniques for surgically assisted rapid maxillary expansion: with or without pterygoid plate detachment. Material and Methods: A longitudinal cohort study sample including ten patients aged 18-40 years, with a skeletal transverse discrepancy in the maxilla of more than 4 mm. Two groups were established on a randomized basis, five patients in each group, according to the detachment or absence of detachment of the pterygoid plate. Furthermore, osteotomies of the bilateral zygomatic buttress and the intermaxillary suture were done in both groups. The transverse discrepancy was measured in study models, a posterior-anterior cephalometric radiograph evaluated the superior and inferior zygomatic plane and the inter-tuber distance and an occlusal radiograph evaluated the intermaxillary dysjunction in the pre-operative period and 30 days post-operatively. A 7-day period of rest was given after corticotomy before starting expansion with quarter turns once a day. Results: There were no statistically significant differences between pre-and post-operative measurements. Conclusion: There are few randomized control trials in literature comparing the two techniques for surgically maxillary expansion. Further studies with a larger sample are required.

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Major vascular complications of orthognathic surgery: Hemorrhage associated with Le Fort I osteotomies

Cited by 175 publications

References 22 publications

Evaluation of Post-operative Complication Rate of Le Fort I Osteotomy: A Retrospective and Prospective Study

Evaluation of Post-operative Complication Rate of Le Fort I Osteotomy: A Retrospective and Prospective Study

Acute Bleeding in the Head and Neck: Angiographic Findings and Endovascular Management

Expansão rápida da maxila cirurgicamente assistida: estudo preliminar

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