Orthognathic Surgery in a Patient with Multiple Sclerosis.

Area of Science:

• Oral and Maxillofacial Surgery
• Neurology
• Immunology

Background:

• Multiple sclerosis (MS) is a progressive central nervous system inflammatory disorder impacting young adults.
• MS can manifest orally with symptoms like facial numbness, pain, and difficulty speaking or swallowing.
• Dental care for MS patients is typically limited to preventive and supportive measures.

Observation:

• A case report details a 23-year-old Saudi male with MS undergoing orthognathic surgery for dentofacial deformity.
• The patient received a Lefort 1 segmental osteotomy under general anesthesia with neurologist and patient consent.
• The patient remained stable throughout surgery and recovery, with no reported MS exacerbations.

Findings:

• Orthognathic and maxillofacial surgery are feasible in MS patients.
• Successful surgical outcomes depend on a strict perioperative prophylactic regimen.
• Stress reduction and prevention of MS attacks are key to safe surgical procedures.

Implications:

• Dental and oral surgeons must be aware of MS manifestations and management strategies.
• Modified treatment approaches are necessary for MS patients undergoing dental and surgical procedures.
• This case highlights the potential for safe surgical intervention in select MS patients with appropriate precautions.