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Yun Y, Kurasawa S, Morita M, Kawachi R, Murata H, Sawada S, Kojima Y, Yagi M, Asako M, Iwai H. Postoperative hemorrhage after Le Fort I osteotomy hemostasis with angiographic embolization: report of two cases. J Surg Case Rep 2023; 2023:rjad663. [PMID: 38111488 PMCID: PMC10725792 DOI: 10.1093/jscr/rjad663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 11/18/2023] [Indexed: 12/20/2023] Open
Abstract
This study reported two cases of acute life-threatening hemorrhage after Le Fort I osteotomy. In both cases, computed tomography and angiography revealed damage to the descending palatine artery, which was successfully treated by angiographic embolization. Although massive hemorrhage after Le Fort I osteotomy is rare, acute hemorrhage from the postoperative area may occur. Angiographic embolization is useful in cases of such hemorrhage from the posterior nasal cavity where endoscopic hemostasis is not possible.
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Affiliation(s)
- Yasutaka Yun
- Department of Otorhinolaryngology, Head & Neck Surgery, Kansai Medical University, Hirakata, Osaka, Japan
| | - Shiro Kurasawa
- Department of Otorhinolaryngology, Head & Neck Surgery, Kansai Medical University, Hirakata, Osaka, Japan
| | - Mizuki Morita
- Department of Otorhinolaryngology, Head & Neck Surgery, Kansai Medical University, Hirakata, Osaka, Japan
| | - Risaki Kawachi
- Department of Otorhinolaryngology, Head & Neck Surgery, Kansai Medical University, Hirakata, Osaka, Japan
| | - Hideyuki Murata
- Department of Otorhinolaryngology, Head & Neck Surgery, Kansai Medical University, Hirakata, Osaka, Japan
| | - Shunsuke Sawada
- Department of Oral and Maxillofacial Surgery, Kansai Medical University, Hirakata, Osaka, Japan
| | - Yuka Kojima
- Department of Oral and Maxillofacial Surgery, Kansai Medical University, Hirakata, Osaka, Japan
| | - Masao Yagi
- Department of Otorhinolaryngology, Head & Neck Surgery, Kansai Medical University, Hirakata, Osaka, Japan
| | - Mikiya Asako
- Department of Otorhinolaryngology, Head & Neck Surgery, Kansai Medical University, Hirakata, Osaka, Japan
| | - Hiroshi Iwai
- Department of Otorhinolaryngology, Head & Neck Surgery, Kansai Medical University, Hirakata, Osaka, Japan
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Khdairi N, Halilah T, Khandakji M, Bartzela T. Rapid Maxillary Expansion Treatment in Patients with Cleft Lip and Palate: A Survey on Clinical Experience in the European Cleft Centers. J Clin Med 2023; 12:jcm12093159. [PMID: 37176600 PMCID: PMC10179601 DOI: 10.3390/jcm12093159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/20/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023] Open
Abstract
Cleft lip and palate patients require complex interdisciplinary treatment, including maxillary expansion and secondary alveolar bone grafting. However, the evidence on these treatment procedures and outcomes is lacking. Therefore, this study aimed to survey the subjective observations of European maxillofacial surgeons and orthodontists on the maxillary expansion and bone grafting treatment protocols and the associated complications. An online questionnaire was sent to 131 centers. The questions assessed the participants' demographic data, maxillary expansion and alveolar bone grafting protocols, and the associated complications. Descriptive statistics and a t-test were used to analyze the data. The response rate was 40.5%. The average age for maxillary expansion was 9-10 years. The secondary alveolar bone grafting was planned 5-10 months after the expansion. The most common complications were asymmetric expansion, relapse, and fistula formation. The protocols and materials used vary widely among centers. Anatomical alterations and developmental processes, like tooth eruption adjacent to the cleft, should be seriously considered for treatment planning. This survey showed that there is still a lack of consensus on these treatment procedures. Further clinical trials should focus on long-term outcome evaluation to identify treatment components for optimal alveolar bone substitution and transversal maxillary expansion treatment in patients with clefts.
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Affiliation(s)
| | | | - Mohannad Khandakji
- Dental Department, Hamad Dental Center, Hamad Medical Cooperation, Doha P.O. Box 3050, Qatar
| | - Theodosia Bartzela
- Department of Orthodontics and Dentofacial Orthopedics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 14197 Berlin, Germany
- Department of Orthodontics, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
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