Le Fort I Osteotomy Complicated by Presence of Maxillary Sinus Septa

Presence of maxillary sinus septa, an anatomical variant, has never been documented as a possible complication of Le Fort I orthognathic surgery procedure. This case report describes the difficulty faced by an experienced surgeon during Le Fort I down-fracture procedure. The osteotomized maxilla remained firm despite confirmation that all osteotomy cuts have been performed adequately. The presence of a bilateral sagittally oriented maxillary sinus septa extending from the floor to the roof of the sinus in this case had prevented separation of the lower maxilla during downfracture maneuver. Such normal anatomical variant must be identified during orthognathic surgery treatment planning session to avoid grave complications.