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Delayed Presentation of a Middle Meningeal Arteriovenous Fistula after Le Fort I Osteotomy
Sean Neo1, Hui-Chai Fong1, Boon Hui Chan2
1Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore, Singapore.
Abstract:
While rare, complications following Le Fort I maxillary osteotomy includes hemorrhage, ischemia, infection, and vascular abnormalities. This study aimed to present an uncommon case of delayed presentation of a middle meningeal pseudoaneurysm formation after Le Fort I osteotomy. The patient initially presented with pulsatile tinnitus, and the pseudoaneurysm was subsequently treated successfully with image-guided embolization.
Insights
A rare complication of Le Fort I osteotomy, a middle meningeal pseudoaneurysm, can present later. This case highlights successful treatment with image-guided embolization for this vascular abnormality.
Area of Science:
- Oral and Maxillofacial Surgery
- Neurosurgery
- Vascular Surgery
Background:
- Le Fort I osteotomy is a surgical procedure to reposition the upper jaw.
- Potential complications, though rare, include vascular abnormalities.
- Delayed presentations of these complications are uncommon.
Observation:
- A patient developed a middle meningeal pseudoaneurysm after Le Fort I osteotomy.
- The initial symptom was pulsatile tinnitus, indicating a vascular issue.
- The pseudoaneurysm presented later than typically expected.
Findings:
- The study details an uncommon case of delayed middle meningeal pseudoaneurysm formation post-Le Fort I osteotomy.
- Diagnosis was confirmed, and the pseudoaneurysm was successfully treated.
- Image-guided embolization proved effective for managing this rare complication.
Implications:
- Highlights the importance of considering rare vascular complications after maxillary osteotomy.
- Emphasizes the efficacy of endovascular treatment for pseudoaneurysms.
- Informs surgical planning and patient monitoring for Le Fort I osteotomy.
