Learning curve in minimally invasive orthognathic surgery

Area of Science:

• Oral and Maxillofacial Surgery
• Surgical Innovation
• Patient Outcomes

Background:

• Minimally invasive orthognathic surgery (MIOS) presents potential benefits over conventional techniques, including reduced patient morbidity and faster recovery.
• The learning curve for mastering MIOS has not been extensively documented, posing a challenge for widespread adoption.
• Understanding the learning curve is crucial for surgeon proficiency and patient safety in MIOS.

Purpose of the Study:

• To evaluate the learning curve associated with minimally invasive orthognathic surgery (MIOS) performed by a single surgeon.
• To assess the impact of surgical experience on key surgical parameters and patient outcomes in MIOS.
• To compare the efficacy and safety of MIOS with conventional orthognathic surgery.

Main Methods:

• A consecutive series of 30 bimaxillary orthognathic surgeries, including genioplasty, were performed using a standardized MIOS protocol.
• Surgical time, intraoperative blood loss, and incision dimensions were systematically measured and analyzed.
• Complications and reoperation rates were recorded to assess safety and learning curve progression.

Main Results:

• A clear learning curve was observed within the first 12 cases, marked by significant improvements in surgical time and reduced blood loss.
• While maxillary incision lengths increased, genioplasty incision sizes significantly decreased, indicating technique refinement.
• Major complications and reoperations were more frequent in the initial cases, decreasing as surgeon proficiency improved.

Conclusions:

• Minimally invasive orthognathic surgery (MIOS) is a safe, feasible, and effective technique with a discernible learning curve.
• The study indicates that MIOS leads to significant reductions in blood loss and hospital stay compared to conventional methods.
• Further research is recommended to validate these findings and develop standardized MIOS protocols.