Internal Carotid Artery Pseudoaneurysm After Le Fort I Osteotomy: Report of a Case and Its Management

Abstract

In the treatment of maxillofacial deformities, the Le Fort I osteotomy is a widely used and versatile procedure. However, complications associated with this procedure are well described and attest to its inherent dangers. The most serious and life-threatening complications are vascular injuries. As reported in the literature, complications primarily involve injury to branches of the external carotid artery, especially the internal maxillary artery, and numerous accounts of intraoperative hemorrhages and management. Accounts of traumatic aneurysms located on branches of the external carotid also exist, yet appear to be rare occurrences. Most of these aneurysms occur in a delayed manner and are primarily associated with projectile injuries or blunt trauma. This case report describes a unique complication, a vascular injury to the internal carotid artery (ICA) in a patient who underwent a Le Fort I osteotomy as part of a procedure to establish a proper maxillomandibular relationship.