[Complications of surgical treatment of mandibular prognathism] Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego [Pol Merkur Lekarski] Journal article

Negative emotions due to violate facial appearance resulting from dentofacial disharmony may affect psychological status and general life adjustment of the patient. This is the origin of clinicians' great responsibility for satisfying result of surgical treatment in patients with mandibular prognathism. The aim of the study was evaluation of incidence of intraoperative and postoperative complications during surgical treatment of mandibular prognathism with bilateral mandibular sagittal ramus osteotomy or mandibular bilateral vertical ramus osteotomy and defining predisposing factors.
MATERIAL AND METHODS: A sample of 37 patients with mandibular prognathism operated in Department of Cranio-Maxillofacial Surgery in Lódź from May 2001 to February 2006 was included into the study. The patients were underwent surgery with mandibular bilateral sagital osteotomy (intraoral approach) or mandibular vertical ramus osteotomy (extraoral approach). Demographic data (gender and age) and medical data (method of surgery, time of hospitalization) were collected. Intraoperative and postoperative complications were recorded as well acceptance of scar.
RESULTS: Facial nerve paralysis immediately after surgery and 6 months after surgery was observed in group of patients operated with vertical ramus osteotomy (6 and 3 patients respectively to time), and released completely after 12 months. Early and permanent paraesthesia was recorded more often in group of patients operated with sagittal split ramus osteotomy (respectively 14/17 and 2/17 for early and permanent paraesthesia) in contrast to 3 of 20 patients operated with vertical ramus osteotomy. Permanent (12 months postoperatively) paraesthesia within third branch of trigeminal nerve were diagnosed more often in patients over 25 years old. 3 patients operated with sagittal split ramus osteotomy demonstrated unilateral wound healing problems and 4 patients operated with vertical ramus osteotomy demonstrated wound healing problems and it was related to unacceptable cicatrix.
CONCLUSIONS: 1. Frequency of intraoperative and postoperative complications in surgical treatment of mandibular prognathism is independent on patients' gender and age. 2. The choice of sagittal split ramus osteotomy is related to higher probability of paraesthesia within lower lip immediately after surgery, but the early risk of facial nerve paralysis is greater after extraoral vertical ramus osteotomy.

Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego [Pol Merkur Lekarski]