Case report: Rare latent postoperative pseudoaneurysm of internal maxillary artery after Le Fort osteotomy

Background

The Le Fort I osteotomy is a commonly employed and predictable surgical technique used to treat maxillofacial deformities. While considered technically safe, orthognathic surgery can cause significant vascular complications. Presentation: This case report describes a 20-year old male who had undergone a routine Le Fort I osteotomy to treat maxillo-mandibular discrepancy, and subsequently developed an internal maxillary artery pseudoaneurysm that caused uncontrolled hemorrhage and hemodynamic instability. The patient ultimately required interventional radiology coil embolization for source control.

Discussion

Although rare, internal maxillary artery pseudoaneurysms continue to be reported as postoperative complications in Le Fort I osteotomies, wherein coil-embolization technique remains a viable option for treatment. Additionally, the presentation of temporal swelling and retrobulbar pain may be useful in diagnosing the existence of a maxillary artery pseudoaneurysm. Conclusion: Pseudoaneurysm of the internal maxillary artery is a possible sequela of orthognathic surgery, and proper monitoring and management can avoid morbid outcomes.