Maxillofac Plast Reconstr Surg.  2022;44(1):29. 10.1186/s40902-022-00359-1.

A rare complication of hemolacria after Le fort I osteotomy: a case presentation

• Helal M
• Gaber R
• El‑Kassaby M

• KMID: 2538631
• DOI: http://doi.org/10.1186/s40902-022-00359-1

Abstract

Background
Nasolacrimal duct obstruction (NDO) is a common pathology preventing the proper drainage of the tears, and its main symptom is epiphora. Secondary acquired nasolacrimal duct obstruction (SANDO) can be due to a variety of causes including infection, trauma, or neoplasms. It has been reported to occur with different forms of maxillofacial trauma, especially Le Fort II, Le Fort III, naso-orbital-ethmoidal, and orbital floor fractures.
Case presentation
A 20-year-old Egyptian female presented to correct a facial disharmony due to a cleft lip and palate defect. The patient reported a history of congenital NDO and had deficient lateral nasal walls. Bimaxillary surgery was planned, including a Le Fort I osteotomy for the maxilla and bilateral sagittal split osteotomy for the mandible. The surgery was uneventful, but the patient complained from bloody tears or hemolacria few days postoperatively. This complication began to cease spontaneously after 2 days and completely recovered after 4 days.
Conclusion
Hemolacria is an infrequent finding after maxillofacial surgeries and may be associated with CLP surgeries more than other surgeries. In this case, it was easily managed, and surgeons should be more aware of it to try to prevent its occurrence.

Keyword

Hemolacria; Bloody tears; Retrograde hemorrhage; Nasolacrimal; Le fort I