Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
J Craniomaxillofac Surg. 2022 Mar;50(3):197-203. doi: 10.1016/j.jcms.2021.11.011. Epub 2021 Dec 2.
This article aimed to review adverse events and complications to orthognathic surgery based upon 10 years. This study was a retrospective investigation between 2009 and 2018. Independent variables such as sex, age, pre-operative conditions, diagnosis, type of surgery, bleeding volume, surgery duration, and hospitalization were recorded. The data regarding orthognathic surgery adverse events and complications were evaluated and statistically analyzed with a significance level of p < 0.05. A total of 891 patients were included in this study (male 39.1%, female 60.9%) with a mean age of 26.4 ± 6.09 years. A neurosensory disturbance was found as immediate post-operative sequelae as 93.5%. The four most frequent complications had a relapse (6.4%), post-operative TMD (5.7%), unfavorable osteotomy (5.5%), and infection (4.9%), which seem to be more common in males. An average blood loss was 497 ± 371 ml and the average operative time was 401 ± 109.3 min. Complication rates were statistically affected by bleeding volume (p-value = 0.01), operative time (p-value = 0.03), and type of skeletal deformity (p-value = 0.01). Although numerous complications were recorded, no fatal complications were experienced. Bleeding time, operative time, and skeletal classification have significant influence on orthognathic surgery complications. However, a multitude of factors could be modified to reduce the complication rate and improve the result of the treatment. One of the most significant factors was the operative time.
本文旨在回顾基于 10 年的正颌手术不良事件和并发症。这项研究是 2009 年至 2018 年的回顾性调查。记录了独立变量，如性别、年龄、术前情况、诊断、手术类型、出血量、手术时间和住院时间。评估了与正颌手术不良事件和并发症相关的数据，并进行了统计学分析，显著性水平为 p < 0.05。本研究共纳入 891 例患者（男性 39.1%，女性 60.9%），平均年龄 26.4 ± 6.09 岁。神经感觉障碍是术后即刻的后遗症，占 93.5%。最常见的四种并发症为复发（6.4%）、术后颞下颌关节紊乱（5.7%）、骨切开不良（5.5%）和感染（4.9%），这些并发症似乎在男性中更为常见。平均出血量为 497 ± 371ml，平均手术时间为 401 ± 109.3min。并发症发生率受出血量（p 值=0.01）、手术时间（p 值=0.03）和骨骼畸形类型（p 值=0.01）的影响。尽管记录了许多并发症，但没有发生致命性并发症。出血时间、手术时间和骨骼分类对正颌手术并发症有显著影响。然而，可以通过多种因素来降低并发症发生率，改善治疗效果。其中最重要的因素之一是手术时间。
