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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/15315

Title: Life-threatening haemorrhage after 750 Le Fort I osteotomies and 376 SARPE procedures
Authors: POLITIS, Constantinus
Issue Date: 2012
Publisher: CHURCHILL LIVINGSTONE
Citation: INTERNATIONAL JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, 41 (6), p. 702-708
Abstract: This study assessed the incidence, presenting symptoms, diagnosis, and management of patients with life-threatening postoperative haemorrhage after total Le Fort I osteotomy and surgically assisted rapid palatal expansion (SARPE). The medical records of 750 consecutive Le Fort 1 osteotomies and 376 consecutive SARPEs, both of which involved pterygomaxillary separation with a curved osteotome and a mallet, were analysed prospectively. Two cases of life-threatening haemorrhage were observed in the Le Fort I osteotomy group, both initiated on postoperative day 7. Anterior and posterior nasal packing were successful in one patient; the other required two embolizations for bleeding control (incidence of life-threatening postoperative haemorrhage: 2/750; confidence interval: 0.03-0.96%). In the SARPE group, one brisk epistaxis on the first postoperative day was controlled with anterior and posterior nasal packing under general anaesthesia. This haemorrhage was not considered life threatening (incidence of life-threatening postoperative haemorrhage: 0/376; confidence interval: 0-0.98%). In no case could the source of bleeding be established during re-explorative surgery or during diagnostic arteriography. The authors conclude that life-threatening haemorrhage is an exceptional finding after Le Fort I osteotomy; the observed incidence was 2/750, and life-threatening haemorrhage was not observed after SARPE in this series, despite the use of identical pterygomaxillary separation.
Notes: Politis, C (reprint author), St Johns Hosp, Dept Oral & Maxillofacial Surg, B-3600 Genk, Belgium. Hasselt Univ, Fac Med, Diepenbeek, Belgium. constantinus.politis@uhasselt.be
URI: http://hdl.handle.net/1942/15315
DOI: 10.1016/j.ijom.2012.02.015
ISI #: 000305368300004
ISSN: 0901-5027
Category: A1
Type: Journal Contribution
Validation: ecoom, 2014
Appears in Collections: Research publications

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