Cranial nerve injury after Le Fort I osteotomy.
A Le Fort I osteotomy is widely used to correct dentofacial deformity because it is a safe and reliable surgical method. Although rare, various complications have been reported in relation to pterygomaxillary separation. Cranial nerve damage is one of the serious complications that can occur after Le Fort I osteotomy. In this report, a 19-year-old man with unilateral cleft lip and palate underwent surgery to correct maxillary hypoplasia, asymmetry and mandibular prognathism. After the Le Fort I maxillary osteotomy, the patient showed multiple cranial nerve damage; an impairment of outward movement of the eye (abducens nerve), decreased vision (optic nerve), and paraesthesia of the frontal and upper cheek area (ophthalmic and maxillary nerve). The damage to the cranial nerve was related to an unexpected sphenoid bone fracture and subsequent trauma in the cavernous sinus during the pterygomaxillary osteotomy.
Kim
J-W
JW
Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea.
Chin
B-R
BR
Park
H-S
HS
Lee
S-H
SH
Kwon
T-G
TG
D020222:Abducens Nerve Injury / Q000209:etiology; D016063:Blood Loss, Surgical; D002426:Cavernous Sinus / Q000293:injuries; D002971:Cleft Lip / Q000601:surgery; D002972:Cleft Palate / Q000601:surgery; D020209:Cranial Nerve Injuries / Q000209:etiology*; D005146:Facial Asymmetry / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008437:Maxilla / Q000002:abnormalities / Q000601:surgery; D008442:Maxillary Nerve / Q000293:injuries; D015835:Ocular Motility Disorders / Q000209:etiology; D009882:Ophthalmic Nerve / Q000293:injuries; D020221:Optic Nerve Injuries / Q000209:etiology; D056948:Orthognathic Surgical Procedures / Q000009:adverse effects*; D019340:Osteotomy, Le Fort / Q000009:adverse effects*; D010292:Paresthesia / Q000209:etiology; D011378:Prognathism / Q000601:surgery; D012887:Skull Fractures / Q000209:etiology; D013100:Sphenoid Bone / Q000293:injuries; D014786:Vision Disorders / Q000209:etiology; D055815:Young Adult