Perioperative complications in corrective facial orthopedic surgery: A 5-year retrospective study
Identifieur interne : 008E35 ( Main/Exploration ); précédent : 008E34; suivant : 008E36Perioperative 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]Source :
- Journal of Oral and Maxillofacial Surgery [ 0278-2391 ] ; 2000.
Descripteurs français
- Wicri :
- topic : Chirurgie.
English descriptors
- KwdEn :
- Adult orthod orthognath surg, Airway, Airway obstruction, American association, Bilateral sagittal split osteotomies, Bsso, Bsso procedures, Buccal, Chin osteotomies, Chin osteotomy, Clercq, Complication, Condylar resorption, Craniomaxillofac surg, Daily doses, Deep venous thrombosis, Facial, Fort osteotomies, Fort osteotomy, Fracture, Frequent complication, General hospital, Hematoma, Hole titanium mesh plates, Incision, Infectious complications, Inferior alveolar nerve, Intensive care unit, Late complications, Lingual, Lingual nerve, Mandibular, Mandibular advancement, Mandibular base, Mandibular base osteotomies, Mandibular prognathism, Mandibular ramus, Mandibular surgery, Marginal branch, Maxillary, Maxillary impaction, Maxillary surgery, Maxillofac, Maxillofac surg, Maxillofacial surgeons, Midcare unit, Mommaerts, Neurosensory disturbances, Oral maxillofac surg, Oral surg, Orthognathic, Orthognathic surgery, Orthopedic surgery, Osteotomized segment, Osteotomy, Osteotomy procedures, Perioperative morbidity, Postoperatively, Proximal segment, Pterygomaxillary dysjunction, Ramus, Retrospective study, Rhinoplastic osteotomies, Sagittal, Sagittal osteotomy, Sagittal split osteotomies, Sagittal split osteotomy, Same surgery, Slot osteosynthesis technique, Surg, Surgery, Surgical drainage, Surgical procedure, Total subapical, Trigeminal nerve, Unfavorable fractures, Unfavorable splits, Vascularization problems, Zygomatic.
- Teeft :
- Adult orthod orthognath surg, Airway, Airway obstruction, American association, Bilateral sagittal split osteotomies, Bsso, Bsso procedures, Buccal, Chin osteotomies, Chin osteotomy, Clercq, Complication, Condylar resorption, Craniomaxillofac surg, Daily doses, Deep venous thrombosis, Facial, Fort osteotomies, Fort osteotomy, Fracture, Frequent complication, General hospital, Hematoma, Hole titanium mesh plates, Incision, Infectious complications, Inferior alveolar nerve, Intensive care unit, Late complications, Lingual, Lingual nerve, Mandibular, Mandibular advancement, Mandibular base, Mandibular base osteotomies, Mandibular prognathism, Mandibular ramus, Mandibular surgery, Marginal branch, Maxillary, Maxillary impaction, Maxillary surgery, Maxillofac, Maxillofac surg, Maxillofacial surgeons, Midcare unit, Mommaerts, Neurosensory disturbances, Oral maxillofac surg, Oral surg, Orthognathic, Orthognathic surgery, Orthopedic surgery, Osteotomized segment, Osteotomy, Osteotomy procedures, Perioperative morbidity, Postoperatively, Proximal segment, Pterygomaxillary dysjunction, Ramus, Retrospective study, Rhinoplastic osteotomies, Sagittal, Sagittal osteotomy, Sagittal split osteotomies, Sagittal split osteotomy, Same surgery, Slot osteosynthesis technique, Surg, Surgery, Surgical drainage, Surgical procedure, Total subapical, Trigeminal nerve, Unfavorable fractures, Unfavorable splits, Vascularization problems, Zygomatic.
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
Url:
DOI: 10.1053/joms.2000.7874
Affiliations:
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<term>Airway obstruction</term>
<term>American association</term>
<term>Bilateral sagittal split osteotomies</term>
<term>Bsso</term>
<term>Bsso procedures</term>
<term>Buccal</term>
<term>Chin osteotomies</term>
<term>Chin osteotomy</term>
<term>Clercq</term>
<term>Complication</term>
<term>Condylar resorption</term>
<term>Craniomaxillofac surg</term>
<term>Daily doses</term>
<term>Deep venous thrombosis</term>
<term>Facial</term>
<term>Fort osteotomies</term>
<term>Fort osteotomy</term>
<term>Fracture</term>
<term>Frequent complication</term>
<term>General hospital</term>
<term>Hematoma</term>
<term>Hole titanium mesh plates</term>
<term>Incision</term>
<term>Infectious complications</term>
<term>Inferior alveolar nerve</term>
<term>Intensive care unit</term>
<term>Late complications</term>
<term>Lingual</term>
<term>Lingual nerve</term>
<term>Mandibular</term>
<term>Mandibular advancement</term>
<term>Mandibular base</term>
<term>Mandibular base osteotomies</term>
<term>Mandibular prognathism</term>
<term>Mandibular ramus</term>
<term>Mandibular surgery</term>
<term>Marginal branch</term>
<term>Maxillary</term>
<term>Maxillary impaction</term>
<term>Maxillary surgery</term>
<term>Maxillofac</term>
<term>Maxillofac surg</term>
<term>Maxillofacial surgeons</term>
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<term>Mommaerts</term>
<term>Neurosensory disturbances</term>
<term>Oral maxillofac surg</term>
<term>Oral surg</term>
<term>Orthognathic</term>
<term>Orthognathic surgery</term>
<term>Orthopedic surgery</term>
<term>Osteotomized segment</term>
<term>Osteotomy</term>
<term>Osteotomy procedures</term>
<term>Perioperative morbidity</term>
<term>Postoperatively</term>
<term>Proximal segment</term>
<term>Pterygomaxillary dysjunction</term>
<term>Ramus</term>
<term>Retrospective study</term>
<term>Rhinoplastic osteotomies</term>
<term>Sagittal</term>
<term>Sagittal osteotomy</term>
<term>Sagittal split osteotomies</term>
<term>Sagittal split osteotomy</term>
<term>Same surgery</term>
<term>Slot osteosynthesis technique</term>
<term>Surg</term>
<term>Surgery</term>
<term>Surgical drainage</term>
<term>Surgical procedure</term>
<term>Total subapical</term>
<term>Trigeminal nerve</term>
<term>Unfavorable fractures</term>
<term>Unfavorable splits</term>
<term>Vascularization problems</term>
<term>Zygomatic</term>
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<term>Airway</term>
<term>Airway obstruction</term>
<term>American association</term>
<term>Bilateral sagittal split osteotomies</term>
<term>Bsso</term>
<term>Bsso procedures</term>
<term>Buccal</term>
<term>Chin osteotomies</term>
<term>Chin osteotomy</term>
<term>Clercq</term>
<term>Complication</term>
<term>Condylar resorption</term>
<term>Craniomaxillofac surg</term>
<term>Daily doses</term>
<term>Deep venous thrombosis</term>
<term>Facial</term>
<term>Fort osteotomies</term>
<term>Fort osteotomy</term>
<term>Fracture</term>
<term>Frequent complication</term>
<term>General hospital</term>
<term>Hematoma</term>
<term>Hole titanium mesh plates</term>
<term>Incision</term>
<term>Infectious complications</term>
<term>Inferior alveolar nerve</term>
<term>Intensive care unit</term>
<term>Late complications</term>
<term>Lingual</term>
<term>Lingual nerve</term>
<term>Mandibular</term>
<term>Mandibular advancement</term>
<term>Mandibular base</term>
<term>Mandibular base osteotomies</term>
<term>Mandibular prognathism</term>
<term>Mandibular ramus</term>
<term>Mandibular surgery</term>
<term>Marginal branch</term>
<term>Maxillary</term>
<term>Maxillary impaction</term>
<term>Maxillary surgery</term>
<term>Maxillofac</term>
<term>Maxillofac surg</term>
<term>Maxillofacial surgeons</term>
<term>Midcare unit</term>
<term>Mommaerts</term>
<term>Neurosensory disturbances</term>
<term>Oral maxillofac surg</term>
<term>Oral surg</term>
<term>Orthognathic</term>
<term>Orthognathic surgery</term>
<term>Orthopedic surgery</term>
<term>Osteotomized segment</term>
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<term>Perioperative morbidity</term>
<term>Postoperatively</term>
<term>Proximal segment</term>
<term>Pterygomaxillary dysjunction</term>
<term>Ramus</term>
<term>Retrospective study</term>
<term>Rhinoplastic osteotomies</term>
<term>Sagittal</term>
<term>Sagittal osteotomy</term>
<term>Sagittal split osteotomies</term>
<term>Sagittal split osteotomy</term>
<term>Same surgery</term>
<term>Slot osteosynthesis technique</term>
<term>Surg</term>
<term>Surgery</term>
<term>Surgical drainage</term>
<term>Surgical procedure</term>
<term>Total subapical</term>
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<term>Unfavorable splits</term>
<term>Vascularization problems</term>
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<front><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>
</front>
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