ABSTRACT
ABSTRACT: Rates of severe complications in orthognathic surgery are low, but when they occur they can be fatal. This article reports a case of laceration of the junction of the posterior lateral nasal artery and the sphenopalatine artery, resulting in severe delayed bleeding. Patient undergoes a multiple segment Le Fort I osteotomy with no intraoperative or immediate postoperative complications. On the fourth postoperative day, he presents with epistaxis and intractable postnasal discharge, is admitted to emergency with signs of shock, and bleeding is detected endoscopically originating from the right sphenopalatine artery, which is treated with diathermocoagulation. The advantage of endoscopy in difficult areas is that bleeding complications can be solved with low morbidity.
Subject(s)
Maxillary Artery , Orthognathic Surgical Procedures , Arteries , Epistaxis/etiology , Humans , Male , Maxillary Artery/surgery , Nose , Osteotomy, Le Fort/adverse effectsABSTRACT
PURPOSE: The aim of this study was to describe a surgical technique that can be used to solve dentofacial deformities associated with narrow interradicular spaces of the anterior teeth of the maxilla and inadequate overbite/overjet seen in hand-articulated models. This is presented here as an alternative to segmentation of the maxilla in Le Fort I osteotomy. METHODS: Six patients with dentofacial deformities (classes II and III malocclusions) had Le Fort I osteotomy accompanied by buccal alveolar corticotomies of the maxilla. During the immediate postoperative period, elastic forces were applied to mobilize the anterior dentoalveolar segments until the planned overjet/overbite was observed. RESULTS: All patients reached the desired occlusion approximately 1 month after the surgical procedure. Pulp vitality of the teeth adjacent to the corticotomies was not compromised. CONCLUSIONS: The clinical results obtained confirm the technique as a safe and reliable alternative to segmentation of the maxilla in orthognathic surgery.
