Division of Oral, Facial and Maxillofacial Surgery, Faculty of Dentistry, Universidad de La Frontera; Oral and Maxillofacial Surgery Unit, Hernán Henríquez Aravena Hospital; Center for Excellence in Morphological and Surgical Studies (CEMyQ), Universidad de La Frontera, Temuco.
Oral and Maxillofacial Surgery Unit, Del Salvador Hospital; Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universidad de Los Andes, Santiago.
J Craniofac Surg. 2021;32(5):e493-e495. doi: 10.1097/SCS.0000000000007455.
Rates of severe complications in orthognathic surgery are low, but when they occur they can be fatal. This article reports a case of laceration of the junction of the posterior lateral nasal artery and the sphenopalatine artery, resulting in severe delayed bleeding. Patient undergoes a multiple segment Le Fort I osteotomy with no intraoperative or immediate postoperative complications. On the fourth postoperative day, he presents with epistaxis and intractable postnasal discharge, is admitted to emergency with signs of shock, and bleeding is detected endoscopically originating from the right sphenopalatine artery, which is treated with diathermocoagulation. The advantage of endoscopy in difficult areas is that bleeding complications can be solved with low morbidity.
正颌外科严重并发症的发生率较低，但发生时可能致命。本文报告一例因后外侧鼻动脉与蝶腭动脉交界处撕裂导致严重延迟性出血的病例。患者行多节段 Le Fort I 截骨术，术中及术后即刻无并发症。术后第 4 天，出现鼻出血和难治性鼻后滴注，因休克征象收入急诊，并经内镜发现出血源自右侧蝶腭动脉，经电凝治疗。内镜在困难部位的优势在于可以用低发病率解决出血并发症。
