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[Severe vascular complications of Le Fort I osteotomy]
P Bouletreau1, H Chemli, J Mortier
1Service de Chirurgie Maxillo-Faciale, Centre Hospitalier Lyon-Sud, 165, Chemin du Grand-Revoyet, 69495 Pierre Bénite cedex, France. pierre.bouletreau@chu-lyon.fr
Insights
Vascular complications following Le Fort I osteotomy are rare, occurring in 0.55% of cases. Hemorrhagic complications, such as pseudo-aneurysms, were the most frequent, requiring embolization for treatment.
Area of Science:
- Oral and Maxillofacial Surgery
- Vascular Surgery
- Anatomic Studies
Background:
- Le Fort I osteotomy is a standard orthognathic surgical procedure.
- The intricate local anatomy poses a risk of severe vascular complications.
- Understanding these risks is crucial for patient safety.
Purpose of the Study:
- To analyze vascular complications from Le Fort I osteotomies performed in a specific department.
- To detail the diagnostic and therapeutic approaches for these complications.
- To discuss strategies for preventing vascular issues.
Main Methods:
- Retrospective analysis of patient records from 1998 to 2007.
- Inclusion of cases undergoing Le Fort I osteotomy.
- Recording of severe vascular complications requiring specific interventions.
Main Results:
- Analysis of 916 patient files (39% male, 61% female; mean age 24.42 years).
- Five patients experienced severe hemorrhagic complications; no ischemic complications were noted.
- Three immediate postoperative hemorrhages and two delayed pseudo-aneurysms treated with embolization.
Conclusions:
- Vascular complications associated with Le Fort I osteotomy are infrequent (0.55% in this series).
- Hemorrhagic complications represent the predominant type of vascular issue encountered.
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.
