An arteriovenous fistula of the maxillary artery as a complication of Le Fort I osteotomy.
BACKGROUND
The Le Fort I osteotomy, one of the most common techniques used to correct dento-midfacial deformities, is generally considered to be operatively safe. However, sometimes this procedure can lead to fatal vascular complications.


METHODS
This article describes a fifty-year-old woman with a giant facial venous malformation. The patient underwent a Le Fort I osteotomy in order to correct an open bite. The surgery was complicated by the development of an arteriovenous fistula (AVF) between the maxillary artery and the venous malformation, the diagnosis of which was made by ultrasound doppler. Neuroradiological embolisation process of the maxillary artery was performed in order to close the AVF.


RESULTS
The total fistula obliteration and a Class I occlusion were obtained.


CONCLUSIONS
The reported case suggests the necessity of a multidisciplinary process (involving both maxillofacial and neuroradiology teams) for the treatment of dento-midfacial deformities in relation to vascular malformations. This modality is the only way to guarantee minimization of morbidity (according to patient's expectations).
Goffinet
Laetitia
L
Department of Oral and Maxillofacial Surgery, Faculty of medicine, University of Tours, France. laetitia.goffinet.pleutret@gmail.com
Laure
Boris
B
Tayeb
Talel
T
Amado
Defne
D
Herbreteau
Denis
D
Arbeille
Philippe
P
Goga
Dominique
D
D000792:Angiography; D001164:Arteriovenous Fistula / Q000209:etiology* / Q000628:therapy; D004621:Embolization, Therapeutic; D005145:Face / Q000098:blood supply / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008437:Maxilla / Q000002:abnormalities* / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery; D008438:Maxillary Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D008875:Middle Aged; D024343:Open Bite / Q000601:surgery; D019340:Osteotomy, Le Fort / Q000009:adverse effects*; D054079:Vascular Malformations / Q000150:complications*