A case of sagittal splitting ramus osteotomy and genioplasty in a patient with congenital factor VII deficiency

Blood coagulation factor VII is involved in the extrinsic clotting system, and congenital defects or deficiencies affecting blood coagulation factor VII are rare. We report the case of a patient who was diagnosed with factor VII deficiency based on a preoperative examination and then underwent factor VII replacement therapy and orthognathic surgery, together with a brief discussion of the literature. The patient was a 25-year-old woman. She presented to our hospital after being diagnosed with jaw deformity and underwent sagittal splitting ramus osteotomy and genioplasty under general anesthesia. Preoperative tests revealed an abnormally short prothrombin time. Blood tests detected very low coagulation factor VII activity (33%), and so the patient was diagnosed with factor VII deficiency. We conducted preoperative factor VII replacement therapy to inhibit bleeding, and then the abovementioned surgical procedure was performed safely. The operative time was 1 hour 30 minutes, and little intraoperative blood loss occurred. The patient’s postoperative course was good, e.g., no abnormal bleeding occurred, and she was discharged on postoperative day 7.