After a LeFort I osteotomy, what might cause aura and diplopia in a patient?

Cavernous sinus thrombosis can lead to aura and diplopia after a LeFort I osteotomy due to its impact on the cranial nerves that control eye movement. The cavernous sinus is a cavity at the base of the skull, located near the sella turcica, which houses cranial structures including the internal carotid artery and cranial nerves III, IV, V1, V2, and VI. During surgical procedures, there is a potential for direct trauma or indirect injury to these structures, especially in cases where there is significant bleeding or manipulation of surrounding tissues.

When thrombosis occurs within the cavernous sinus, it can impede venous drainage and increase intracranial pressure, leading to symptoms such as visual disturbances (diplopia) due to the involvement of the cranial nerves, particularly the abducens nerve (CN VI) which controls lateral eye movement. Additionally, the alteration in blood flow dynamics can produce neurological symptoms such as aura, which may manifest as visual or sensory disturbances preceding or accompanying the diplopia. This highlights the importance of closely monitoring such patients for neurological signs postoperatively, as timely management can prevent further complications.