Rupture of pseudoaneurysm of the posterolateral nasal artery associated to Le Fort I osteotomy: a case report

Background: It is unusual to find a life-threatening hemorrhage as a postoperative complication of a Le Fort I osteotomy. However, there are reports related to the maxillary artery, and its branches, including the terminal branch, the sphenopalatine artery. Therefore, every surgeon performing this procedure must know this type of complication and the appropriate workflow to resolve it. This case is unique in terms of elucidating the clinical signs of symptoms that can be evidenced with a ruptured pseudoaneurysm after orthognathic surgery and how minimally invasive non-surgical procedures can resolve this complication. Case Description: In this paper, we present the case of a 26-year-old male with no pertinent past medical history who presented with three postoperative episodes of epistaxis after a Le Fort I osteotomy for correction of class III craniofacial anomaly; this was secondary to a ruptured pseudoaneurysm of the posterolateral nasal artery, a branch of the sphenopalatine artery; the patient underwent embolization as definitive treatment. No bleeding episode was reported after definitive treatment with embolization, the patient continued with post-op follow-up appointments with no complications. Conclusions: It is considered that making this type of reports contributes to the formation of the international community, enhances knowledge, and facilitates what to do when a hemorrhagic complication associated with a surgical procedure of orthognathic surgery occurs.