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Does the Type of Maxillomandibular Deformity Influence Complication Rate in Orthognathic Surgery?
Reza Tabrizi1, Hamidreza Pakshir, Bahar Nasehi
1*Global Oral and Maxillofacial Research Center, Tehran †Orthodontic Research Center, Shiraz University of Medical Sciences; and ‡ School of Dentistry, International Branch, Shiraz University of Medical Sciences, Shiraz, Iran.
Purpose:
Patients may encounter various complications during and after orthognathic surgery. The aim of this study was to compare the prevalence of complications in various skeletal deformities to see if an association exists.
Materials And Methods:
This retrospective cohort study assessed patients in 2 groups. Group 1 had class III skeletal deformity and group 2 had class II skeletal deformity with vertical maxillary excess (VME). Complications were studied in 2 stages: Stage 1 included perioperative and immediate (first 24 hours) postoperative complications namely difficult intubation, blood transfusion, bad splits, pain, and postoperative airway problems. Stage 2 included postoperative complications (from 24 hours up to 6 months after surgery namely bad splits and relapse). Age, sex, operation time, and the amount of jaw movements were considered as variables. Types of skeletal deformity were predictive factor of the study.
Results:
The authors studied 248 patients in 2 groups. In group 1, 13 (8.2%) patients needed blood transfusion during surgery up to 24 hours after operation and 27 (30%) patients in group 2. Analysis of data demonstrated a significant difference for blood transfusion between 2 groups (P = 0.001). In group 1, 8 (5.1%) patients had a difficult intubation compared with 13 (14.4%) patients in group 2.Comparison of mandibular movement and maximum mouth opening (MMO) did not show significant differences between 2 groups (P > 0.05). The amount of maxillary movement and horizontal discrepancy were different statistically in 2 groups (P < 0.05). Analysis of the data showed a significant difference in intubation between the 2 groups (P < 0.05). There were no differences between the 2 groups for bad splits, postoperative airway problems, or paresthesia (P > 0.05). Results did not demonstrate a significant difference for pain between the 2 groups (P > 0.05).
Conclusions:
Patients with class II skeletal deformity and VME may have higher risk of perioperative blood loss and difficult intubation compared with patients with class III skeletal deformity.
