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Perioperative complications in corrective facial orthopedic surgery: A 5-year retrospective study

Identifieur interne : 008E35 ( Main/Exploration ); précédent : 008E34; suivant : 008E36

Perioperative complications in corrective facial orthopedic surgery: A 5-year retrospective study

Auteurs : Faustino Acebal-Bianco [Belgique] ; Philippe L. P. J. Vuylsteke [Belgique] ; Maurice Y. Mommaerts [Belgique] ; Calix A. S. De Clercq [Belgique]

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RBID : ISTEX:85678058D470469ED99A0EA0540D6524B1C2F55D

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Abstract

Abstract: Purpose: Frequency and severity of complications have a profound impact on referral patterns for facial orthopedic surgery. Therefore, a retrospective study was undertaken to determine the incidence of such problems in a large series of patients, with the intent to use these data to make possible changes in the perioperative protocol used in our clinic. Patients and Methods: The files of all patients operated on between 1992 and 1996 were studied. These comprised 1,108 patients with 1,872 osteotomy procedures. The following parameters were descriptively analyzed: airway obstruction, hemorrhage, hematoma, infection, neurosensory disturbances, unfavorable fractures, malposition of condyles and nasal septum, and vascularization problems. Results: The most frequent complication was impairment of trigeminal nerve function. In 31.5% of the mandibular base osteotomies, 43.6% of the combined mandibular base and chin osteotomies, and 13% of the chin osteotomies, lip sensibility was decreased immediately postoperatively. After 1 year, this number was reduced to approximately 5%. The function of 17 lingual nerves and 45 infraorbital nerves was temporarily impaired. A wound infection was next in frequency. Fifty-three infections (mandible-to-maxilla ratio, 2.5:1) were treated with drainage under local anesthesia and antibiotic therapy. Loss of part or all of an osteotomized segment did not occur. Other complications were rare and/or temporary. Conclusions: The most frequent complication was impairment of inferior alveolar nerve function. Life-threatening complications were not encountered. The frequency of infections (<5%) requires further consideration regarding ways to reduce the incidence. © 2000 American Association of Oral and Maxillofacial Surgeons

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DOI: 10.1053/joms.2000.7874


Affiliations:


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<div type="abstract" xml:lang="en">Abstract: Purpose: Frequency and severity of complications have a profound impact on referral patterns for facial orthopedic surgery. Therefore, a retrospective study was undertaken to determine the incidence of such problems in a large series of patients, with the intent to use these data to make possible changes in the perioperative protocol used in our clinic. Patients and Methods: The files of all patients operated on between 1992 and 1996 were studied. These comprised 1,108 patients with 1,872 osteotomy procedures. The following parameters were descriptively analyzed: airway obstruction, hemorrhage, hematoma, infection, neurosensory disturbances, unfavorable fractures, malposition of condyles and nasal septum, and vascularization problems. Results: The most frequent complication was impairment of trigeminal nerve function. In 31.5% of the mandibular base osteotomies, 43.6% of the combined mandibular base and chin osteotomies, and 13% of the chin osteotomies, lip sensibility was decreased immediately postoperatively. After 1 year, this number was reduced to approximately 5%. The function of 17 lingual nerves and 45 infraorbital nerves was temporarily impaired. A wound infection was next in frequency. Fifty-three infections (mandible-to-maxilla ratio, 2.5:1) were treated with drainage under local anesthesia and antibiotic therapy. Loss of part or all of an osteotomized segment did not occur. Other complications were rare and/or temporary. Conclusions: The most frequent complication was impairment of inferior alveolar nerve function. Life-threatening complications were not encountered. The frequency of infections (<5%) requires further consideration regarding ways to reduce the incidence. © 2000 American Association of Oral and Maxillofacial Surgeons</div>
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