Department of Oral, Cranio-Maxillofacial and Facial Plastic Surgery, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60596, Frankfurt, Germany.
Department of Oral, Maxillofacial and Facial Plastic Surgery, Sana Klinikum, Starkenburgring 66, Offenbach am Main, Germany.
Oral Maxillofac Surg. 2023 Jun;27(2):341-351. doi: 10.1007/s10006-022-01073-y. Epub 2022 May 20.
To retrospectively compare the high-angled sagittal split osteotomy (HOO) and the bilateral sagittal split osteotomy (BSSO) for the correction of skeletal dysgnathias regarding intra- and postoperative complications.
The electronic medical records of all patients treated with an orthognathic surgery at the Department for Oral, Maxillofacial and Facial Plastic Surgery, University Hospital Frankfurt, Germany, between the years 2009 and 2019 were retrospectively reviewed.
Two hundred ninety-one patients were included. The overall complication rates were 19.78% (BSSO) compared to 12.5% (HOO) (p = 0.14). Significant differences were found regarding the operation time (HOO < BSSO, p = 0.02), material failure (HOO > BSSO, p = 0.04), and early recurrence requiring revision surgery (HOO < BSSO, p = 0.002). The use of a ramus plate significantly reduced the risk of plate failure (2.8% < 13.6%, p = 0.05). More bad splits (p = 0.08) and early sensory disorders (p = 0.07) occurred in the BSSO group.
The HOO presents a possible alternative to the BSSO since newly developed osteosynthesis material significantly reduces the risk of material failure. The BSSO is accompanied by higher risks of developing complications like a bad split and sensory disorders but, however, remains the standard for large anterior-posterior transpositions of the mandible.
回顾性比较高角矢状劈开截骨术（HOO）和双侧矢状劈开截骨术（BSSO）治疗颌骨发育不良的手术并发症。
回顾性分析 2009 年至 2019 年期间在德国法兰克福大学医院口腔颌面外科接受正颌手术的所有患者的电子病历。
共纳入 291 例患者。BSSO 组的总并发症发生率为 19.78%，而 HOO 组为 12.5%（p=0.14）。HOO 组的手术时间明显短于 BSSO 组（HOO<BSSO，p=0.02），HOO 组的器械断裂发生率高于 BSSO 组（HOO>BSSO，p=0.04），HOO 组的早期复发需要再次手术的发生率低于 BSSO 组（HOO<BSSO，p=0.002）。使用下颌支固定板可显著降低器械断裂的风险（2.8%<13.6%，p=0.05）。BSSO 组更易出现不良劈裂（p=0.08）和早期感觉障碍（p=0.07）。
与 BSSO 相比，HOO 是一种可行的替代方法，因为新开发的内固定材料可显著降低器械断裂的风险。BSSO 存在更高的并发症风险，如劈裂和感觉障碍，但仍是治疗大型前后向下颌骨移位的标准方法。
