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Intraoperative Computed Tomography in Bilateral Sagittal Split Osteotomy.

Jimoh Olubanwo Agbaje1, Ahmed Sobhy Salem2, Ivo Lambrichts3

  • 1OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Leuven, Belgium.

Journal of Maxillofacial and Oral Surgery
|November 12, 2016
PubMed
Summary
This summary is machine-generated.

Intraoperative computed tomography (CT) aids inferior alveolar nerve safety during bilateral sagittal split osteotomy. This imaging technique helps assess and modify treatment, improving nerve health outcomes in orthognathic surgery.

Keywords:
Computed tomographyInferior alveolar nerveOrthognathic surgeryOsteotomySagittal split ramus

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Medical Imaging
  • Neurosurgery

Background:

  • Bilateral sagittal split osteotomy (BSSO) is a common orthognathic procedure.
  • Inferior alveolar nerve (IAN) injury is a potential complication of BSSO.
  • Assessing IAN position and integrity during surgery is crucial for patient outcomes.

Purpose of the Study:

  • To evaluate the utility of intraoperative computed tomography (CT) in safeguarding the inferior alveolar nerve (IAN) during bilateral sagittal split osteotomy (BSSO).
  • To demonstrate how intraoperative CT can guide surgical decisions and improve IAN outcomes.

Main Methods:

  • Ten patients undergoing BSSO for orthognathic reasons were included.
  • Intraoperative CT scans were performed before and after osteosynthesis.
  • Neurosensory testing (light touch, self-reporting) assessed IAN function postoperatively.

Main Results:

  • Transient hypoesthesia of the lower lip was observed in 80% of patients at 6 weeks.
  • Diminished sensation improved significantly, with only 20% affected at 6 months.
  • All patients achieved normal labial sensibility by the final follow-up.

Conclusions:

  • Intraoperative CT provides real-time assessment of surgical site and IAN status.
  • The ability to modify treatment intraoperatively enhances IAN safety.
  • Intraoperative CT is a valuable tool for improving postoperative IAN health in orthognathic surgery.