Transient abducens nerve palsy following a Le Fort I maxillary osteotomy: report of a case.

A case of transient abducens nerve palsy following Le Fort I maxillary osteotomy is reported. The results of the CT scan strongly suggest the cause was a fracture of the body of the sphenoid bone but the cause of the fracture is unclear. The palsy occurred on the first postoperative day and recovery took approximately 5 months. The most likely explanation for the complication is a transmittal of force from the osteotome used to fracture through the pterygoid plates extending superiorly through the medial surface of the cavernous sinus. This case clearly demonstrates the importance of care in positioning of the pterygomaxillary osteotome.