A Novel Device for Blood Drainage after Le Fort I Osteotomy: Maxillary Sinus Ventilation Drainage (MSVD).

Ui-Lyong Lee,Young-Jun Choi,Han-Wool Choung,Hyo-Won Jang,Sei-Young Lee

doi:10.3390/jcm11030562

Abstract

The purpose of this study is to present a novel maxillary sinus ventilation drainage (MSVD) device which facilitates blood drainage and nasal breathing after Le Fort I osteotomy. One hundred patients who underwent bimaxillary orthognathic surgery from January 2016 to June 2016 at the Department of Oral and Maxillofacial Surgery, Chung-Ang University Hospital were retrospectively selected and divided into two groups. MSVD was applied in 50 patients, who were allocated to the MSVD group, while the remaining 50 patients, in whom MSVD was not applied, were allocated to the non-MSVD group. All patients underwent a cone-beam computed tomography (CBCT) scan before and 2 days after surgery. CBCT was used to analyze middle meatus patency and the percentage of hematoma volume per entire maxillary sinus volume. Statistical comparisons between the two groups were performed using the Chi-squared and Mann–Whitney U tests to investigate the clinical effectiveness of MSVD. The MSVD group showed significantly higher maintenance ratio of the middle meatus patency and a higher percentage of maxillary sinus air volume (p < 0.05) than the non-MSVD group. MSVD facilitated nasal breathing after Le Fort I osteotomy by reducing hematoma inside the maxillary sinus and promoting middle meatal patency.

Highlights

Since von Langenbeck first described Le Fort I osteotomy in 1859, it has become a routine procedure for bimaxillary orthognathic surgery [1,2]
Postoperative oozing from the maxillary sinus might favor the formation of endobronchial blood clots through the nasopharynx, which may result in airway obstruction [8]
This study evaluated 100 patients who underwent bimaxillary orthognathic surgery from January 2016 to June 2016 at the Department of Oral and Maxillofacial Surgery, Chung-Ang University Hospital

Summary

Introduction

Since von Langenbeck first described Le Fort I osteotomy in 1859, it has become a routine procedure for bimaxillary orthognathic surgery [1,2]. Postoperative complications related to hemorrhage are prevalent [3]. Drainage of the hematoma in a surgical wound is considered effective in reducing infection [6]. Nasal stuffiness is another hemorrhagic complication after Le Fort I osteotomy caused by sino-nasal hematoma, which blocks the middle meatus. According to questionnaires regarding postoperative patient complaints, the worst subjective symptom after bimaxillary orthognathic surgery is nasal stuffiness, with a frequency of about 55.6% [7]. Appropriate blood drainage from the maxillary sinuses is necessary to reduce such complications

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Conclusion