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An Unusual Occurrence of Iatrogenic Midline Oronasal Communication Following Lefort 1 Osteotomy: A Case Report
Manikandhan Ramanathan1,2, A I Raj2, Keerthana Ponvel2
1Meenakshi Cleft and Craniofacial Center, Maduravoyal, Chennai, 600095 India.
Abstract:
Lefort 1 Osteotomy, a common procedure for midface correction, carries inherent risks including oronasal fistulas, though iatrogenic occurrences are rare. We present a unique case of a 22-year-old male developing a 5 mm oronasal communication postoperatively. Despite initial observation, the communication spontaneously closed within three weeks. CT scans confirmed palatal bone disruption. This iatrogenic complication highlights the importance of meticulous surgical technique, particularly in patients with high-arch palates. Strategies such as careful osteotome angulation and preoperative CT evaluation are crucial. While uncommon, awareness of this complication is vital for optimal patient management. Further research is warranted to refine surgical approaches and minimize associated risks. This case underscores the necessity for tailored surgical planning and vigilant post-operative monitoring to ensure favourable outcomes.

