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      Incidence of Complications Associated with Mandibuloplasty: A Review of 588 Cases over 5 Years

      review-article
      , MD
      Plastic and Reconstructive Surgery Global Open
      Wolters Kluwer Health

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          Abstract

          Supplemental Digital Content is available in the text.

          Abstract

          Background:

          The number of patients undergoing mandibuloplasty in East Asia has increased in recent years. Angle resection, corticectomy, and tubercle excisions are the most commonly used methods of mandibuloplasty. However, no data are available on complications following mandibuloplasty. This study aimed to determine the prevalence and significance of intra- and postoperative complications associated with mandibuloplasty.

          Methods:

          A total of 588 Korean patients (99 men, 489 women; age range, 19–62 years) who underwent mandibuloplasty (performed by a single surgeon in the same clinic) were divided into 4 groups: group I, angle resection (190); group II, angle resection and genioplasty, including tubercle excision (130); group III, angle resection and zygoma reduction (114); and group IV, angle resection, genioplasty, and zygoma reduction (154). The average follow-up period was 14 weeks.

          Results:

          The most common complication was numbness. Of 38 patients (6.46%) with sensory deficits, 16 (2.72%), 11 (1.87%), and 11 (1.87%) patients reported these changes around the chin, lower lip, and intraoral incision areas at postoperative 6 months and 3, 1, and 5 patients reported these changes at postoperative 1 year, respectively. Infection occurred in 19 patients (3.23%) within 2 weeks and was resolved with IV antibiotics in 1–2 weeks in 17 patients but was unresolved in 2 after 3 months. Hemifacial palsy, intraoperative bleeding requiring transfusion, and hardness and burning sensation were also noted in 1 patient.

          Conclusions:

          Surgeons must be aware of the complications of mandibuloplasty and their occurrence rates.

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          Most cited references18

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          Incidence of complications and problems related to orthognathic surgery: a review of 655 patients.

          This retrospective report evaluates the incidence of pre-, intra-, and postoperative complications of orthognathic surgery and their significance to the patient. The clinical records and radiographs of 655 patients operated on in Vaasa Central Hospital, Finland during a 13-year period between 1983 and 1996 were examined. The total number of operations was 689. All notes referring to problems or complications from the orthodontic phase to the varying postoperative follow-up times were gathered and analyzed. The most common complication was a neurosensory deficit in the region innervated by the inferior alveolar nerve; mild in 32% of patients (183 of 574 patients with an osteotomy in the mandible) and disturbing in 3% of patients (18/574). The most serious complication was severe intraoperative bleeding in 1 patient necessitating major blood transfusions and later embolization of the internal maxillary artery. There were no fatal complications. The incidence of other problems was low, and there were very few patient complaints. Despite the great variety of severe complications reported in the literature, their frequency seems to be extremely low, and orthognathic surgery treatment can be considered to be a safe procedure. Copyright 2001 American Association of Oral and Maxillofacial Surgeons
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            Incidence of complications and problems related to orthognathic surgery.

            This retrospective report evaluates the incidence of intra- and postoperative complications of orthognathic surgery and their relevance. The clinical records and radiographs of 301 patients who underwent surgery at Chosun University Dental Hospital, Korea, over an 8-year period between 1998 and 2005 were examined. The most common complication was a neurosensory deficit in the region innervated by the inferior alveolar nerve. The most serious complication was severe intraoperative bleeding. No complication was fatal. Despite the great variety of severe complications reported, their frequency seems to be extremely low. Orthognathic surgery appears to be a safe procedure.
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              Prevalence of postoperative complications after orthognathic surgery: a 15-year review.

              This study was conducted to determine the prevalence of postoperative complications after orthognathic surgery and evaluate the use of antibiotic prophylaxis in relation to the infection rate. All patients undergoing orthognathic procedures between 1990 and 2004 were studied retrospectively by retrieving their individual medical records. Demographic data, intraoperative data (specific orthognathic procedures and duration of operation), and postoperative data (type and duration of antibiotic prophylaxis and presence of postoperative complications) were recorded. Patients noted to have suffered any postoperative complications were studied in detail, and various factors, including gender, age, duration of operation, and use of prophylactic antibiotics, were analyzed using statistical tests in relation to postoperative infection. A total of 2,910 orthognathic procedures were performed on 1,294 consecutive patients in the 15-year period, with 1,070 patients undergoing bimaxillary procedures and 224 patients undergoing single-jaw surgery. The orthognathic surgery-related complication rate was 9.7%, of which 7.4% was related to postoperative infection. Of the cases of infection, 58.3% were acute infection and 41.7% were chronic infection. Patients who received a single preoperative dose of antibiotics had a significantly higher infection rate (17.3%) than those who received postoperative antibiotics for various durations. The prevalence of infection after orthognathic surgery was relatively low given the complexity of the procedures. No particular orthognathic procedure was more susceptible to infection. A preoperative dose of prophylactic antibiotics together with at least 2 days of postoperative doses was useful in reducing the infection rate compared with only a single dose of prophylactic antibiotics.
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                Author and article information

                Journal
                Plast Reconstr Surg Glob Open
                Plast Reconstr Surg Glob Open
                GOX
                Plastic and Reconstructive Surgery Global Open
                Wolters Kluwer Health
                2169-7574
                April 2014
                07 May 2014
                : 2
                : 4
                : e139
                Affiliations
                From the Division of Plastic and Reconstructive surgery, Romian Plastic Surgery Clinic, Seoul, Republic of Korea.
                Author notes
                Minbum Kang, MD Romian Plastic Surgery Clinic 8F, Glass Tower 406, Gangnam-daero Gangnam-gu Seoul 135-080 Republic of Korea E-mail: minbum.kang@ 123456gmail.com
                Article
                00003
                10.1097/GOX.0000000000000090
                4174213
                fb4ab8b4-2d4e-451c-99d3-73c6222d5dca
                Copyright © 2014 The Authors. Published by Lippincott Williams & Wilkins on behalf of The American Society of Plastic Surgeons. PRS Global Open is a publication of the American Society of Plastic Surgeons.

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivitives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.

                History
                : 12 December 2014
                : 03 March 2014
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