In this report we describe three very different and interesting compli
cations of the Le Fort I osteotomy. The first case is of a unilateral
third nerve palsy developing as a result of a carotid-cavernous fistul
a and false aneurysm of the internal carotid artery. The second compli
cation to be reported is total unilateral blindness. The third case is
one of total avulsion of a lateral segment of the palate in a patient
with a complete bilateral cleft of the primary and secondary palates.
all complications were the result of a Le Fort I osteotomy performed
for correction of midface hypoplasia secondary to congenital cleft lip
and palate. The literature is reviewed, and the pathomechanics of eac
h injury are hypothesized.