Preoperative, intraoperative, and postoperative complications in orthognathic surgery: a systematic review

M Jędrzejewski, T Smektała, K Sporniak-Tutak, R Olszewski, M Jędrzejewski, T Smektała, K Sporniak-Tutak, R Olszewski

Abstract

Objectives: The aim of this study was to determine whether orthognathic surgery is associated with any complications, and what type of complications may occur.

Materials and methods: Data were obtained using PubMed (MEDLINE), ISI Web of Knowledge, Ovid, Cochrane Library, Embase Library, and an additional manual search. The titles and abstracts of the electronic search results were screened and evaluated by two observers for eligibility according to the inclusion and exclusion criteria.

Results: A total of 1924 articles were identified, and we retained 44 articles for the final analysis. The Prisma diagram flowchart demonstrates our selection scheme. For the purpose of this study, the Cochrane data extraction form was modified. One review author extracted data from the included studies, and the second author checked all of the forms. The hierarchy of evidence classification from the UK NHS Centre for Reviews and Dissemination was used to assess the level of evidence for the retrieved studies.

Conclusions: An evaluation of the obtained studies revealed the existence of a large number of varied complications associated with orthognathic surgery procedures.

Clinical relevance: Oral and maxillofacial surgeons, orthodontists, and the surgical team need to prevent such complications during preoperative, intraoperative, and postoperative periods to increase the safety of orthognathic surgery procedures. This review was registered on http://www.crd.york.ac.uk/PROSPERO as CRD42013004711.

Figures

Fig. 1
Fig. 1
PRISMA diagram flowchart

References

    1. Ow A, Cheung LK. Skeletal stability and complications of bilateral sagittal split osteotomies and mandibular distraction osteogenesis: an evidence-based review. J Oral Maxillofac Surg. 2009;67(11):2344–2353. doi: 10.1016/j.joms.2008.07.003.
    1. Ruiz LP, Lara JC. Facial nerve palsy following bilateral sagittal split ramus osteotomy for setback of the mandible. Int J Oral Maxillofac Surg. 2011;40(8):884–886. doi: 10.1016/j.ijom.2011.02.030.
    1. Chrcanovic BR, Custódio AL. Optic, oculomotor, abducens, and facial nerve palsies after combined maxillary and mandibular osteotomy: case report. J Oral Maxillofac Surg. 2011;69(6):e234–e241. doi: 10.1016/j.joms.2011.01.001.
    1. Rai KK, Shivakumar HR, Sonar MD. Transient facial nerve palsy following bilateral sagittal split ramus osteotomy for setback of the mandible: a review of incidence and management. J Oral Maxillofac Surg. 2008;66(2):373–378. doi: 10.1016/j.joms.2006.06.257.
    1. Piñeiro-Aguilar A, Somoza-Martín M, Gandara-Rey JM, García-García A. Blood loss in orthognathic surgery: a systematic review. J Oral Maxillofac Surg. 2011;69(3):885–892. doi: 10.1016/j.joms.2010.07.019.
    1. Nemeth DZ, Rodrigues-Garcia RC, Sakai S, Hatch JP, Van Sickels JE, et al. Bilateral sagittal split osteotomy and temporomandibular disorders: rigid fixation versus wire fixation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;89(1):29–34. doi: 10.1016/S1079-2104(00)80010-4.
    1. Ow A, Cheung LK. Bilateral sagittal split osteotomies versus mandibular distraction osteogenesis: a prospective clinical trial comparing inferior alveolar nerve function and complications. Int J Oral Maxillofac Surg. 2010;39(8):756–760. doi: 10.1016/j.ijom.2010.04.001.
    1. Essick GK, Phillips C, Turvey TA, Tucker M. Facial altered sensation and sensory impairment after orthognathic surgery. Int J Oral Maxillofac Surg. 2007;36(7):577–582. doi: 10.1016/j.ijom.2007.02.006.
    1. Phillips C, Essick G, Blakey G, 3rd, Tucker M. Relationship between patients' perceptions of postsurgical sequelae and altered sensations after bilateral sagittal split osteotomy. J Oral Maxillofac Surg. 2007;65(4):597–607. doi: 10.1016/j.joms.2005.12.078.
    1. Politi M, Toro C, Costa F, Polini F, Robiony M. Intraoperative awakening of the patient during orthognathic surgery: a method to prevent the condylar sag. J Oral Maxillofac Surg. 2007;65(1):109–114. doi: 10.1016/j.joms.2005.10.064.
    1. Reyneke JP, Ferretti C. Intraoperative diagnosis of condylar sag after bilateral sagottal split Ramus osteotomy. Br J Oral Maxillofac Surg. 2002;40:285–292. doi: 10.1016/S0266-4356(02)00147-X.
    1. Gunaseelan R, Anantanarayanan P, Veerabahu M, Vikraman B, Sripal R. Intraoperative and perioperative complications in anterior maxillary osteotomy: a retrospective evaluation of 103 patients. J Oral Maxillofac Surg. 2009;67(6):1269–1273. doi: 10.1016/j.joms.2008.12.051.
    1. Kahnberg KE, Ridell A. Transposition of the mental nerve in orthognathic surgery. J Oral Maxillofac Surg. 1987;45(4):315–318. doi: 10.1016/0278-2391(87)90351-X.
    1. Kramer FJ, Baethge C, Swennen G, Teltzrow T, Schulze A. Intra- and perioperative complications of the LeFort I osteotomy: a prospective evaluation of 1000 patients. J Craniofac Surg. 2004;15(6):971–977. doi: 10.1097/00001665-200411000-00016.
    1. Li KK, Stephens W. Fractures of the atrophic, edentulous maxilla during Le Fort I osteotomy. Int J Oral Maxillofac Surg. 1996;25(6):430–432. doi: 10.1016/S0901-5027(96)80077-4.
    1. Wittwer G, Adeyemo WL, Beinemann J, Juergens P. Evaluation of risk of injury to the inferior alveolar nerve with classical sagittal split osteotomy technique and proposed alternative surgical techniques using computer-assisted surgery. Int J Oral Maxillofac Surg. 2012;41(1):79–86. doi: 10.1016/j.ijom.2011.08.001.
    1. Teerijoki-Oksa T, Jääskeläinen SK, Forssell K, Forssell H, Vähätalo K. Risk factors of nerve injury during mandibular sagittal split osteotomy. Int J Oral Maxillofac Surg. 2002;31(1):33–39. doi: 10.1054/ijom.2001.0157.
    1. Veras RB, Kriwalsky MS, Hoffmann S, Maurer P, Schubert J. Functional and radiographic long-term results after bad split in orthognathic surgery. Int J Oral Maxillofac Surg. 2008;37(7):606–611. doi: 10.1016/j.ijom.2008.04.010.
    1. O'Regan B, Bharadwaj G. Prospective study of the incidence of serious posterior maxillary haemorrhage during a tuberosity osteotomy in low level Le Fort I operations. Br J Oral Maxillofac Sur. 2007;45(7):538–542. doi: 10.1016/j.bjoms.2007.03.006.
    1. Alpha C, O'Ryan F, Silva A, Poor D. The incidence of postoperative wound healing problems following sagittal ramus osteotomies stabilized with miniplates and monocortical screws. J Oral Maxillofac Surg. 2006;64(4):659–668. doi: 10.1016/j.joms.2005.12.013.
    1. Politis C. Life-threatening haemorrhage after 750 Le Fort I osteotomies and 376 SARPE procedures. Int J Oral Maxillofac Surg. 2012;41(6):702–708. doi: 10.1016/j.ijom.2012.02.015.
    1. Kobayashi T, Izumi N, Kojima T, Sakagami N, Saito I, et al. Progressive condylar resorption after mandibular advancement. Br J Oral Maxillofac Surg. 2012;50(2):176–180. doi: 10.1016/j.bjoms.2011.02.006.
    1. Pereira-Filho VA, Gabrielli MF, Gabrielli MA, Pinto FA, Rodrigues-Junior AL, et al. Incidence of maxillary sinusitis following Le Fort I osteotomy: clinical, radiographic, and endoscopic study. J Oral Maxillofac Surg. 2011;69(2):346–351. doi: 10.1016/j.joms.2010.07.038.
    1. Hu J, Wang D, Zou S. Effects of mandibular setback on the temporomandibular joint: a comparison of oblique and sagittal split ramus osteotomy. J Oral Maxillofac Surg. 2000;58(4):375–380. doi: 10.1016/S0278-2391(00)90915-7.
    1. Gulses A, Aydintug YS, Sencimen M, Bayar GR, Acikel CH. Evaluation of neurosensory alterations via clinical neurosensory tests following anterior maxillary osteotomy (Bell technique) Int J Oral Maxillofac Surg. 2012;41(11):1353–1360. doi: 10.1016/j.ijom.2012.03.021.
    1. Stewart TD, Sexton J. Depression: a possible complication of orthognathic surgery. J Oral Maxillofac Surg. 1987;45(10):847–851. doi: 10.1016/0278-2391(87)90234-5.
    1. Neal CE, Kiyak HA. Patient perceptions of pain, paresthesia, and swelling after orthognathic surgery. Int J Adult Orthodon Orthognath Surg. 1991;6(3):169–181.
    1. Yaghmaei M, Ghoujeghi A, Sadeghinejad A, Aberoumand D, Seifi M, et al. Auditory changes in patients undergoing orthognathic surgery. Int J Oral Maxillofac Surg. 2009;38(11):1148–1153. doi: 10.1016/j.ijom.2009.06.002.
    1. Teerijoki-Oksa T, Jääskeläinen SK, Soukka T, Virtanen A, Forssell H. Subjective sensory symptoms associated with axonal and demyelinating nerve injuries after mandibular sagittal split osteotomy. J Oral Maxillofac Surg. 2011;69(6):e208–e213. doi: 10.1016/j.joms.2011.01.024.
    1. Kuroyanagi N, Miyachi H, Ochiai S, Kamiya N, Kanazawa T, Nagao T, Shimozato K. Prediction of neurosensory alterations after sagittal split ramus osteotomy. Int J Oral Maxillofac Surg. 2012;42(7):814–822. doi: 10.1016/j.ijom.2012.11.016.
    1. Gianni AB, D'Orto O, Biglioli F, Bozzetti A, Brusati R. Neurosensory alterations of the inferior alveolar and mental nerve after genioplasty alone or associated with sagittal osteotomy of the mandibular ramus. J Craniomaxillofac Surg. 2002;30(5):295–303. doi: 10.1054/jcms.2002.0311.
    1. Ylikontiola L, Kinnunen J, Laukkanen P, Oikarinen K. Prediction of recovery from neurosensory deficit after bilateral sagittal split osteotomy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;90(3):275–281. doi: 10.1067/moe.2000.108920.
    1. Onizawa K, Schmelzeisen R, Vogt S. Alteration of temporomandibular joint symptoms after orthognathic surgery: comparison with healthy volunteers. J Oral Maxillofac Surg. 1995;53(2):117–121. doi: 10.1016/0278-2391(95)90383-6.
    1. Gent JF, Shafer DM, Frank ME. The effect of orthognathic surgery on taste function on the palate and tongue. J Oral Maxillofac Surg. 2003;61(7):766–773. doi: 10.1016/S0278-2391(03)00152-6.
    1. Kobayashi A, Yoshimasu H, Kobayashi J, Amagasa T. Neurosensory alteration in the lower lip and chin area after orthognathic surgery: bilateral sagittal split osteotomy versus inverted L ramus osteotomy. J Oral Maxillofac Surg. 2006;64(5):778–784. doi: 10.1016/j.joms.2006.01.009.
    1. Beshkar M, Hasheminasab M, Mohammadi F. Benign paroxysmal positional vertigo as a complication of orthognathic surgery. J Craniomaxillofac Surg. 2013;41(1):59–61. doi: 10.1016/j.jcms.2012.05.012.
    1. Hanzelka T, Foltán R, Pavlíková G, Horká E, Sedý J. The role of intraoperative positioning of the inferior alveolar nerve on postoperative paresthesia after bilateral sagittal split osteotomy of the mandible: prospective clinical study. Int J Oral Maxillofac Surg. 2011;40(9):901–906. doi: 10.1016/j.ijom.2011.04.002.
    1. Wong LL, Samman N, Whitehill TL. Are hearing and middle ear statuses at risk in Chinese patients undergoing orthognathic surgery? Clin Otolaryngol Allied Sci. 2002;27(6):480–484. doi: 10.1046/j.1365-2273.2002.00616.x.
    1. Schultze-Mosgau S, Krems H, Ott R, Neukam FW. A prospective electromyographic and computer-aided thermal sensitivity assessment of nerve lesions after sagittal split osteotomy and Le Fort I osteotomy. J Oral Maxillofac Surg. 2001;59(2):128–138. doi: 10.1053/joms.2001.20480.
    1. Høgevold HE, Mobarak KA, Espeland L, Krogstad O, Skjelbred P. Plate fixation of extra-oral subcondylar ramus osteotomy for correction of mandibular prognathism: clinical aspects and short term stability. J Craniomaxillofac Surg. 2001;29(4):205–211. doi: 10.1054/jcms.2001.0224.
    1. Thygesen TH, Bardow A, Helleberg M, Norholt SE, Jensen J. Risk factors affecting somatosensory function after sagittal split osteotomy. J Oral Maxillofac Surg. 2007;66(3):469–474. doi: 10.1016/j.joms.2007.06.666.
    1. Barker GR. Auditory tube function and audiogram changes following corrective orthognathic maxillary and mandibular surgery in cleft and non-cleft patients. Scand J Plast Reconstr Surg Hand Surg. 1987;21(1):133–138. doi: 10.3109/02844318709083592.
    1. Posnick JC, Al-Qattan MM, Stepner NM. Alteration in facial sensibility in adolescents following sagittal split and chin osteotomies of the mandible. Plast Reconstr Surg. 1996;97(5):920–927. doi: 10.1097/00006534-199604001-00006.
    1. Thygesen TH, Bardow A, Norholt SE, Jensen J, Svensson P. Surgical risk factors and maxillary nerve function after Le Fort I osteotomy. J Oral Maxillofac Surg. 2009;67(3):528–536. doi: 10.1016/j.joms.2008.07.004.
    1. Al-Delayme R, Al-Khen M, Hamdoon Z, Jerjes W. Skeletal and dental relapses after skeletal class III deformity correction surgery: single-jaw versus double-jaw procedures. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;115(4):466–472. doi: 10.1016/j.oooo.2012.08.443.
    1. Ji-Young L, Young-Kyun K, Pil-Young Y, Nam-Ki L, Jong-Wan K, et al. Evaluation of Stability After Orthognathic Surgery With Minimal Orthodontic Preparation: Comparison According to 3 Types of Fixation. J Craniofac Surg. 2014;25(3):911–915. doi: 10.1097/SCS.0000000000000609.
    1. Prazeres LDKT, Muniz YVS, Barros KMA, Gerbi MEM, Laureano Filho JR. Effect of Infrared Laser in the Prevention and Treatment of Paresthesia in Orthognathic Surgery. J Craniof Surg. 2013;24(3):708–711.
    1. Calabria F, Sellek L, Gugole F, Trevisol L, Bertolasi L, et al. J Craniof Surg. 2013;24(2):514–517. doi: 10.1097/SCS.0b013e3182801d14.
    1. Van der Vlis M, Dentino KM, Vervloet B, Padwa BL. J Oral Maxillofac Surg. 2014;72(11):2241–2247. doi: 10.1016/j.joms.2014.04.026.
    1. Wassmund M. Lehrbuch der praktischen Chirurgie des Mundes und der Kiefer. Leipzig: Hermann Meusser; 1939.
    1. Trauner R, Obwegeser H. Zur Operationstechnik bei der Progenie und anderen Unterkieferanomalien. Dtsch Zahn Mund-u Kieferheilk. 1955;23:11.
    1. Piecuch JF, West RA. Spontaneous pneumomediastinum associated with orthognathic surgery. A case report. Oral Surg Oral Med Oral Pathol. 1979;48(6):506–508. doi: 10.1016/0030-4220(79)90294-9.
    1. Bays RA, Bouloux GF. Complications of orthognathic surgery. Oral Maxillofac Surg Clin North Am. 2003;15(2):229–242. doi: 10.1016/S1042-3699(02)00098-5.
    1. Wolford LM, Reiche-Fischel O, Mehra P. Changes in temporomandibular joint dysfunction after orthognathic surgery. J Oral Maxillofac Surg. 2003;61(6):655–660. doi: 10.1053/joms.2003.50131.
    1. Hori M, Okaue M, Hasegawa M, Harada D, Kamogawa D. Worsening of pre-existing TMJ dysfunction following sagittal split osteotomy: a study of three cases. J Oral Sci. 1999;41(3):133–139. doi: 10.2334/josnusd.41.133.
    1. Hwang SJ, Haers PE, Sailer HF. The role of a posteriorly inclined condylar neck in condylar resorption after orthognathic surgery. J Craniomaxillofac Surg. 2000;28(2):85–90. doi: 10.1054/jcms.2000.0129.

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