OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
Department of Human Genetics, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
Oral Maxillofac Surg. 2023 Jun;27(2):235-243. doi: 10.1007/s10006-022-01054-1. Epub 2022 Mar 28.
To review the experience with orthognathic surgery in patients with systemic diseases, syndromic conditions or an oncological history at a tertiary center.
All patients who had undergone orthognathic surgery and all patients who were considered for orthognathic surgery between January 2013 and August 2020 at a tertiary center were retrospectively reviewed. Patients with cleft lip/palate and orthognathic patients requiring craniofacial surgery or reconstructive surgery were excluded. Patients with an underlying disorder were identified and divided into 3 categories: systemic disease, syndromic condition, or oncological disease treated with chemotherapy and/or radiation therapy of the head and neck. Data on intraoperative and postoperative complications until 3 months after surgery were collected for the patients who had undergone surgery. If orthognathic surgery was contraindicated, the reason was extracted from the patient's medical record.
Eighty out of 1049 orthognathic patients had an underlying disorder (7.6%), including 50 patients with at least one systemic disease, 25 patients with a syndromic condition, and 5 patients with an oncological disease. A complication was encountered in respectively 5 (10%), 9 (36%), and 0 (0%) patients. Three out of 1134 patients who consulted the multidisciplinary orthognathic-orthodontic consultation had a contraindication for orthognathic surgery because of an underlying disease (0.3%).
Based on our findings, intraoperative and short-term postoperative complications in patients with an underlying disorder are not frequent. Contraindications for orthognathic surgery because of a medical condition are very rare.
回顾在一家三级中心，患有系统性疾病、综合征或头颈部接受过放化疗的肿瘤病史的患者行正颌手术的经验。
回顾性分析 2013 年 1 月至 2020 年 8 月期间在一家三级中心行正颌手术的所有患者，以及考虑行正颌手术的所有患者。排除唇腭裂患者和需要颅颌面手术或重建手术的正颌患者。识别出有潜在疾病的患者，并将其分为 3 类：系统性疾病、综合征或接受头颈部放化疗的肿瘤性疾病。收集了行手术患者的围手术期和术后 3 个月内的并发症数据。如果正颌手术有禁忌，则从患者的病历中提取禁忌的原因。
1049 例正颌患者中有 80 例（7.6%）存在潜在疾病，包括 50 例至少有 1 种系统性疾病、25 例综合征和 5 例肿瘤性疾病。分别有 5 例（10%）、9 例（36%）和 0 例（0%）患者发生并发症。1134 例咨询多学科正颌-正畸会诊的患者中，有 3 例（0.3%）因潜在疾病存在正颌手术禁忌。
根据我们的发现，有潜在疾病的患者术中及短期术后并发症并不常见。因医疗状况而存在正颌手术禁忌证的情况非常少见。
