양악 수술 후 발생한 가성동맥류로 인한 대량 비출혈 치험 1예

Orthognathic surgery is widely used to correct congenital and acquired dentofacial deformities. In a variety of orthognathic procedure, Le Fort I osteotomy is procedure performed between posterior wall of maxilla and pterygoid process of sphenoid bone. Although rare, iatrogenic pseudoaneurysm can be occurred in this procedure. As a result, life-threatening hemorrhage can be happened as a rare complication. The following case report describes an episode of delayed massive epistaxis, after a Le Fort I osteotomy for the treatment of cosmetic problem. Emergent angiographic evaluation demonstrated an internal maxillary artery pseudoaneurysm into maxillary sinus and embolization was successfully perfomed. This report reconfirms the importance of maintaining a high clinical suspicion for pseudoaneurysm as a possible etiology of delayed postoperative bleeding in patients after Le Fort I osteotomy. (J Clinical Otolaryngol 2013;24:238–241)