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勒福Ⅰ型截骨术术后并发症发生率的评估:一项回顾性和前瞻性研究。

Evaluation of Post-operative Complication Rate of Le Fort I Osteotomy: A Retrospective and Prospective Study.

作者信息

Garg Sandeep, Kaur Supreet

机构信息

Department of Cranio Maxillofacial Plastic and Reconstructive Surgery, College of Dental Sciences, Davangere, Karnataka 577 004 India ; Gian Sagar Dental College & Hospital, Flat No. 301, NRI 'C' Block, District Patiala, Rajpura, Punjab 140 401 India.

Department of Cranio Maxillofacial Plastic and Reconstructive Surgery, College of Dental Sciences, Davangere, Karnataka 577 004 India.

出版信息

J Maxillofac Oral Surg. 2014 Jun;13(2):120-7. doi: 10.1007/s12663-012-0457-4. Epub 2012 Dec 14.

Abstract

Le Fort I osteotomy has become a routine procedure in elective orthognathic surgery. This procedure is often associated with significant but rare post-operative complications. The study was conducted to evaluate the rate of post-operative complications following conventional Le Fort I osteotomy. Twenty-five healthy adult patients who had to undergo Le Fort I osteotomy without segmentalization of maxilla were included in the study based on indications of surgery. All the patients were followed up for a period of 6 months post-operatively to assess the rate of various post-operative complications such as neurosensory deficit, pulpal sensibility, maxillary sinusitis, vascular complications, aseptic necrosis, unfavourable fractures, ophthalmic complications and instability or non-union of maxilla, etc. The results of our study showed a post-operative complications rate of 4 %. Neurosensory deficit and loss of tooth sensibility were the most common findings during patient evaluation at varying follow-up periods while one patient presented with signs and symptoms of maxillary sinusitis post-operatively. Neurosensory as well as sinusitis recovery took place in almost all the patients within 6 months. It was concluded that thorough understanding of pathophysiological aspects of various complications, careful assessment, treatment planning and the use of proper surgical technique as well as instrumentation may help in further reducing the complication rate.

摘要

勒福Ⅰ型截骨术已成为择期正颌外科手术中的常规操作。该手术常伴有严重但罕见的术后并发症。本研究旨在评估传统勒福Ⅰ型截骨术后的并发症发生率。基于手术指征,25例必须接受上颌骨未分段的勒福Ⅰ型截骨术的健康成年患者被纳入研究。所有患者术后随访6个月,以评估各种术后并发症的发生率,如神经感觉障碍、牙髓感觉、上颌窦炎、血管并发症、无菌性坏死、不良骨折、眼科并发症以及上颌骨不稳定或骨不连等。我们的研究结果显示术后并发症发生率为4%。在不同随访期的患者评估中,神经感觉障碍和牙齿感觉丧失是最常见的表现,而1例患者术后出现上颌窦炎的症状和体征。几乎所有患者在6个月内神经感觉障碍以及鼻窦炎均得以恢复。得出的结论是,深入了解各种并发症的病理生理方面、仔细评估、治疗规划以及使用适当的手术技术和器械可能有助于进一步降低并发症发生率。

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