Immediate and Late Complications After Midface Osteotomies

Despite all surgical advances in the field of orthognathic surgery, serious intra- as well as postoperative complications can occur with midface osteotomies. The standard use of three-dimensional imaging in preoperative planning of orthognathic procedures has led to a better understanding of the anatomy, so that the incidence of these complications has decreased to low levels. The overall complication rate is reported to be 4%, with some studies in the literature reporting an overall complication rate of 6-9%. Immediate and indirect complications of Le Fort I and II osteotomies include vascular complications (hemorrhage, arteriovenous fistulae), aseptic necrosis, maxillary sinusitis, sensory deficits, nasal septal deviations, changes in the position of the nose, loss of tooth vitality/sensitivity, undesirable bad fractures toward the base of the skull and in the pterygoid region, ophthalmologic complications, maxillary malpositioning, bony nonunion, maxillary instability, and relapse.