Weinberg Yves, de O. Andriola Fernando, Swennen Gwen R. J.
Oral and Maxillofacial Surgery Division of Surgery, Barzilai University Medical Center, Ashkelon, Israel
Department of Oral and Maxillofacial Surgery, Hospital São Lucas, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
To increase patient’s postoperative comfort and experience, to enhance fast recovery and decrease patient morbidity after minimally invasive (MI) orthognathic surgery, the overall conditions are also of major importance. In this chapter, important preoperative, perioperative, and postoperative considerations are outlined. Preoperatively, the orthognathic surgical workup in combination with clinical focused 3D virtual surgical planning (3D-VSP) is crucial. Perioperative considerations in regard to the surgical-anesthesiologic team, preparation of the operating room, surgical instrumentation table organization, patient preparation, hypotensive anesthesia, and adequate medication are described in detail. Last but not least, postoperative considerations such as patient and wound care, pain and postoperative nausea/vomiting (PONV) management, dietary support, thermo-therapy, manual lymphatic drainage (MLD), and close patient follow-up will be finally highlighted. In conclusion, besides MI orthognathic surgical techniques performed with delicate and dedicated MI orthognathic surgical instruments, a crucial part of the “Minimally Invasive Orthognathics Algorithm” remains the conditions described in this chapter in order to enhance quality of life (QoL) of patients with maxillofacial deformity undergoing orthognathic / orthofacial surgery.
为提高患者术后舒适度和体验，促进微创正颌手术后快速康复并降低患者发病率，整体条件也至关重要。在本章中，将概述术前、围手术期和术后的重要注意事项。术前，正颌外科检查结合临床聚焦的三维虚拟手术规划（3D-VSP）至关重要。详细描述了围手术期在手术-麻醉团队、手术室准备、手术器械台整理、患者准备、控制性降压麻醉和适当用药方面的注意事项。最后但同样重要的是，将重点强调术后注意事项，如患者及伤口护理、疼痛及术后恶心/呕吐（PONV）管理、饮食支持、热疗、手动淋巴引流（MLD）以及密切的患者随访。总之，除了使用精致且专用的微创正颌手术器械进行微创正颌手术技术外，“微创正颌算法”的关键部分仍然是本章所述的条件，以提高接受正颌/正脸手术的颌面部畸形患者的生活质量（QoL）。
