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Complete Reoperation in Orthognathic Surgery.

Robin T Wu1, Alexander T Wilson1, Cyril S Gary1

  • 1From the Department of Surgery, Section of Plastic Surgery, Yale University School of Medicine.

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|April 30, 2019
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Summary
This summary is machine-generated.

Reoperative orthognathic surgery, often needed for malposition and asymmetry, presents unique challenges but yields good patient satisfaction. This study details factors and outcomes of repeated jaw surgeries.

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Orthodontics
  • Surgical Planning

Background:

  • Complete reoperation involves repeated jaw osteotomies after prior orthognathic surgery.
  • Understanding the reasons and challenges of reoperation is crucial for improving patient outcomes.

Purpose of the Study:

  • To describe jaw positions before and after reoperative orthognathic surgery.
  • To identify factors necessitating reoperation.
  • To outline the technical challenges associated with reoperative orthognathic surgery.

Main Methods:

  • Included patients who underwent repeated orthognathic surgery over 1 year after their primary procedure.
  • Compiled demographic, radiologic, and perioperative data.
  • Compared repeated osteotomies (Le-Fort, sagittal split osteotomy, genioplasty) with primary procedures using statistical analysis.

Main Results:

  • Fifteen patients (71% female, mean age 28.1 years) were analyzed.
  • Iatrogenic bony malposition and asymmetry were primary reasons for reoperation, while relapse was less common.
  • Reoperative procedures involved more 3D planning, all three osteotomies, longer operative times, and hardware removal, yet achieved good anatomical outcomes and 100% patient satisfaction.

Conclusions:

  • Reoperative orthognathic surgery is challenging and infrequently reported.
  • Primary surgery often addresses sagittal discrepancies, whereas reoperation corrects malposition and asymmetry.
  • Despite challenges like re-planning and hardware removal, outcomes and patient acceptance are favorable.