Hwang Dae Seok, Choi Hong Seok, Kim Uk Kyu, Song Jae-Min
Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, South Korea.
J Craniofac Surg. 2019 Sep;30(6):1815-1819. doi: 10.1097/SCS.0000000000005536.
Cleft lip/palate is a facial anomaly caused by an abnormal developmental process. It is also the most common congenital anomaly. Orthognathic surgery is required in 25% of patients with cleft lip and palate for the correction of dentofacial deformity. There are various complications that can occur after orthognathic surgery. Complications that can occur during surgery include bleeding, improper fracture, and injuries to the inferior alveolar nerve (IAN) and lingual nerve. Meanwhile, postoperative complications include hemorrhage, edema, pain, infection, and delayed union or nonunion. This study retrospectively examines the complications that occurred after the orthognathic surgery in cleft lip/palate patients at Pusan National University Dental Hospital.
From June 1, 2008 to July 31, 2017, we selected 17 patients who underwent orthognathic surgery for cleft lip/palate at the Department of Oral and Maxillofacial Surgery, Pusan National University Dental Hospital. The patients were treated at different hospitals for all operations related to cleft lip/palate.
Intraoperative complications include hemorrhage, inadequate fracture, injury to the IAN and lingual nerve, root damage, and fistula. The patients who were evaluated included 2 patients with inadequate fracture, 3 patients with injury to the IAN, and 1 patient with fistula. Postoperative complications (e.g., as damage of the inferior alveolar nerve and velopharyngeal insufficiency) may occur, and all patients recovered during the follow-up period of 6 months or more after the surgery. The relapse rates were A-N per 14.0%, Pog-N per 15.1%, SNA 24.4%, and SNB 4.6%. There was no statistically significant difference in relapse rate.
Complications that may occur after the orthognathic surgery in the patients with cleft lip/palate are similar to those without cleft lip/palate.
唇腭裂是一种由异常发育过程导致的面部畸形。它也是最常见的先天性畸形。25%的唇腭裂患者需要进行正颌手术来矫正牙颌面畸形。正颌手术后可能会出现各种并发症。手术期间可能出现的并发症包括出血、骨折不当以及下牙槽神经(IAN)和舌神经损伤。同时,术后并发症包括出血、水肿、疼痛、感染以及愈合延迟或不愈合。本研究回顾性分析了釜山国立大学牙医院唇腭裂患者正颌手术后发生的并发症。
从2008年6月1日至2017年7月31日,我们选取了在釜山国立大学牙医院口腔颌面外科接受唇腭裂正颌手术的17例患者。这些患者所有与唇腭裂相关的手术均在不同医院进行。
术中并发症包括出血、骨折不充分、IAN和舌神经损伤、牙根损伤以及瘘管。接受评估的患者中,有2例骨折不充分,3例IAN损伤,1例瘘管。术后可能会出现并发症(如下牙槽神经损伤和腭咽闭合不全),所有患者在术后6个月或更长时间的随访期内均康复。复发率为A-N 14.0%,Pog-N 15.1%,SNA 24.4%,SNB 4.6%。复发率无统计学显著差异。
唇腭裂患者正颌手术后可能出现的并发症与非唇腭裂患者相似。