title: Blindness after Le Fort I osteotomy: a possible complication associated with pterygomaxillary separation.
abstract: BACKGROUND
  Visual loss after Le Fort I osteotomy is a devastating complication the mechanism of which is not always clear.
  
  
  METHODS
  A case report of blindness following Le Fort I osteotomy is presented. The literature on the various skull base complications associated with Le Fort I osteotomies is reviewed and the mechanisms of these complications discussed.
  
  
  CONCLUSIONS
  The radiological findings in this case are similar to those previously reported. They strongly support the hypothesis that an adverse transmission of forces associated with pterygomaxillary separation via the sphenoid bone to the intra- and extracranial portions of the skull base is the main reason for injury to the optic and other cranial nerves as well as to the branches of the carotid artery.
authors.affiliation: Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo, Brazil. aavecruz@fmrp.usp.br
authors.forename: Antonio Augusto V
authors.initials: AA
authors.lastname: Cruz
authors.forename: Antonio Carlos
authors.initials: AC
authors.lastname: dos Santos
mesh_terms: D000328:Adult; D001766:Blindness / Q000209:etiology*; D005260:Female; D018460:Fractures, Comminuted / Q000209:etiology; D006801:Humans; D008440:Maxillary Fractures / Q000150:complications / Q000209:etiology; D008443:Maxillary Sinus / Q000293:injuries; D020221:Optic Nerve Injuries / Q000209:etiology*; D019340:Osteotomy, Le Fort / Q000009:adverse effects*; D019291:Skull Base / Q000293:injuries; D012887:Skull Fractures / Q000150:complications* / Q000209:etiology*; D013100:Sphenoid Bone / Q000293:injuries; D013101:Sphenoid Sinus / Q000293:injuries