Le Fort I Osteotomy Complicated by Presence of Maxillary Sinus Septa

Presence of maxillary sinus septa, an anatomical variant, has never been documented as a possible complication of Le Fort I orthognathic surgery procedure. This case report describes the difficulty faced by an experienced surgeon during Le Fort I down-fracture procedure. The osteotomized maxilla remained firm despite confirmation that all osteotomy cuts have been performed adequately. The presence of a bilateral sagittally oriented maxillary sinus septa extending from the floor to the roof of the sinus in this case had prevented separation of the lower maxilla during down-fracture maneuver. Such normal anatomical variant must be identified during orthognathic surgery treatment planning session to avoid grave complications.