正颌外科手术后神经感觉障碍的危险因素。
Risk factors of neurosensory disturbance following orthognathic surgery.
作者信息
Alolayan Albraa Badr, Leung Yiu Yan
机构信息
Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong.
出版信息
PLoS One. 2014 Mar 5;9(3):e91055. doi: 10.1371/journal.pone.0091055. eCollection 2014.
OBJECTIVES
To report the incidence of objective and subjective neurosensory disturbance (NSD) after orthognathic surgery in a major orthognathic centre in Hong Kong, and to investigate the risk factors that contributed to the incidence of NSD after orthognathic surgery.
MATERIALS AND METHODS
A retrospective cross-sectional study on NSD after orthognathic surgery in a local major orthognathic centre. Patients who had bimaxillary orthognathic surgery reviewed at post-operative 6 months, 12 months or 24 months were recruited to undergo neurosensory tests with subjective and 3 objective assessments. Possible risk factors of NSD including subjects' age and gender, surgical procedures and surgeons' experience were analyzed.
RESULTS
238 patients with 476 sides were recruited. The incidences of subjective NSD after maxillary procedures were 16.2%, 13% and 9.8% at post-operative 6 months, 12 months and 24 months, respectively; the incidences of subjective NSD after mandibular procedures were 35.4%, 36.6% and 34.6% at post-operative 6 months, 12 months and 24 months, respectively. Increased age was found to be a significant risk factor of NSD after orthognathic surgery at short term (at 6 months and 12 months) but not at 24 months. SSO has a significantly higher risk of NSD when compared to VSSO. SSO in combination with anterior mandibular surgery has a higher risk of NSD when compared to VSSO in combination with anterior mandibular surgery or anterior mandibular surgery alone. Gender of patients and surgeons' experience were not found to be risk factors of NSD after orthognathic surgery.
CONCLUSION
The incidence of NSD after maxillary and mandibular orthognathic procedures at post-operative 6 months, 12 months and 24 months was reported. Increased age was identified as a risk factor of short term post-operative NSD but not in long term (24 months or more). Specific mandibular procedures were related to higher incidence of NSD after orthognathic surgery.
目的
报告香港一家主要正颌中心正颌手术后客观和主观神经感觉障碍（NSD）的发生率，并调查导致正颌手术后NSD发生率的风险因素。
材料与方法
对当地一家主要正颌中心正颌手术后的NSD进行回顾性横断面研究。招募在术后6个月、12个月或24个月接受双颌正颌手术复查的患者，进行主观和3项客观评估的神经感觉测试。分析NSD的可能风险因素，包括受试者的年龄和性别、手术程序以及外科医生的经验。
结果
招募了238例患者共476侧。上颌手术后主观NSD的发生率在术后6个月、12个月和24个月分别为16.2%、13%和9.8%；下颌手术后主观NSD的发生率在术后6个月、12个月和24个月分别为35.4%、36.6%和34.6%。发现年龄增加是正颌手术后短期内（6个月和12个月）NSD的显著风险因素，但在24个月时不是。与垂直矢状劈开截骨术（VSSO）相比，矢状劈开截骨术（SSO）发生NSD的风险显著更高。与VSSO联合下颌前部手术或单独下颌前部手术相比，SSO联合下颌前部手术发生NSD的风险更高。未发现患者性别和外科医生经验是正颌手术后NSD的风险因素。
结论
报告了上颌和下颌正颌手术后6个月、12个月和24个月时NSD的发生率。年龄增加被确定为术后短期NSD的风险因素，但长期（24个月及以上）不是。特定的下颌手术与正颌手术后NSD的较高发生率相关。
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