Skip to main content Accessibility help

Massive epistaxis due to pseudoaneurysm of the sphenopalatine artery: a rare post-operative complication of orthognathic surgery

  • Y-W Kim (a1), M-J Baek (a1), H-D Kim (a2) and K-S Cho (a3)



To introduce pseudoaneurysm of the sphenopalatine artery as the possible aetiology of acute massive epistaxis in patients with a history of orthognathic surgery accompanied by Le Fort I osteotomy.


Case report and literature review.


This paper reports a case of acute life-threatening epistaxis following Le Fort I osteotomy. Computed tomography and angiography showed a pseudoaneurysm of the sphenopalatine artery, which was successfully treated by endovascular embolisation.


Although a pseudoaneurysm of the sphenopalatine artery following Le Fort I osteotomy is extremely rare, it should be considered as the possible aetiology of acute massive epistaxis in patients with a history of orthognathic surgery accompanied by Le Fort I osteotomy.


Corresponding author

Address for correspondence: Dr K-S Cho, Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University School of Medicine, 1-10 Ami-dong, Seo-gu, Busan 602-739, South Korea Fax: 82-51-246-8668 E-mail:


Hide All
1Chepla, KJ, Totonchi, A, Hsu, DP, Gosain, AK. Maxillary artery pseudoaneurysm after Le Fort I osteotomy: treatment using transcatheter arterial embolization. J Craniofac Surg 2010;21:1079–81
2Panula, K, Finne, K, Oikarinen, K. Incidence of complications and problems related to orthognathic surgery: a review of 655 patients. J Oral Maxillofac Surg 2001;59:1128–36
3Zachariades, N, Rallis, G, Papademetriou, G, Papakosta, V, Spanomichos, G, Souelem, M. Embolization for the treatment of pseudoaneurysm and transection of facial vessels. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;92:491–4
4Bradley, JP, Elahi, M, Kawamoto, HK. Delayed presentation of pseudoaneurysm after Le Fort I osteotomy. J Craniofac Surg 2002;13:746–50
5Silva, AC, O'Ryan, F, Beckley, ML, Young, HY, Poor, D. Pseudoaneurysm of a branch of the maxillary artery following mandibular sagittal split ramus osteotomy: case report and review of the literature. J Oral Maxillofac Surg 2007;65:1807–16
6Manafi, A, Ghenaati, H, Dezham, F, Arshad, M. Massive repeated nose bleeding after bimaxillary osteotomy. J Craniofac Surg 2007;18:1491–3
7Pappa, H, Richardson, D, Niven, S. False aneurysm of the facial artery as complication of sagittal split osteotomy. J Craniomaxillofac Surg 2008;36:180–2
8Bynoe, RP, Kerwin, AJ, Parker, HH 3rd, Nottingham, JM, Bell, RM, Yost, MJ et al. Maxillofacial injuries and life-threatening hemorrhage: treatment with transcatheter arterial embolization. J Trauma 2003;55:74–9
9Zhang, C, Xie, X, You, C, Mao, B, Wang, C, He, M et al. Endovascular treatment of traumatic pseudoaneurysm presenting as intractable epistaxis. Korean J Radiol 2010;11:603–11



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed