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Perioperative Systemic Corticosteroids in Orthognathic Surgery: A Systematic Review and Meta-Analysis.

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Systemic corticosteroids in orthognathic surgery did not reduce reintubation or hospital stay. While they decreased facial edema, evidence for their benefit is weak due to inconsistent reporting of side effects.

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Anesthesiology
  • Pharmacology

Background:

  • Perioperative systemic corticosteroids are commonly used in orthognathic surgery to mitigate complications.
  • However, their efficacy and potential adverse effects remain uncertain.

Purpose of the Study:

  • To systematically review and meta-analyze the impact of perioperative systemic corticosteroids on key outcomes in orthognathic surgery patients.

Main Methods:

  • A systematic review of randomized controlled trials (RCTs) was conducted, searching multiple databases.
  • Primary outcome: postoperative reintubation. Secondary outcomes: hospital length of stay, facial edema reduction, and adverse events.
  • Data were synthesized using Mantel-Haenszel random-effects models.

Main Results:

  • Eight RCTs (234 patients) were included; none assessed reintubation risk.
  • No significant difference in hospital length of stay was found.
  • Systemic corticosteroids significantly reduced facial edema (SMD -1.07; 95% CI -1.99 to -0.16).
  • Reported adverse events included bleeding, hypersensitivity, and stomach discomfort. Risk of bias was unclear across trials.

Conclusions:

  • Systemic corticosteroids show no benefit regarding reintubation or hospital stay in orthognathic surgery.
  • While facial edema reduction was observed, inconsistent adverse event reporting limits conclusions.
  • Current evidence does not strongly support the routine use of systemic steroids in orthognathic surgery.