Abstract
Objective. To investigate the factors affecting intraoperative hemorrhage and postoperative sequelae after orthognathic surgery. Materials and Methods. Eighty patients with mandibular prognathism underwent surgical mandibular setback with intraoral vertical ramus osteotomy (IVRO). The correlation between the blood loss volume and postoperative VAS with the gender, age, and operating time was assessed using the t-test and Spearman rank correlation coefficient. The correlation between the magnitude of mandibular setback with the presence of TMJ clicking symptoms and lip sensation was also assessed. Results. The mean operating time and blood loss volume for men and women were 249.52 min and 229.39 min, and 104.03 mL and 86.12 mL, respectively. The mean VAS in men and women was 3.21 and 2.93, and 1.79 and 1.32 on the first and second postoperative days. There is no gender difference in the operating time, blood loss, VAS, TMJ symptoms, and lip numbness. The magnitude of mandibular setback was not correlated with immediate and long-term postoperative lip numbness. Conclusion. There are no gender differences in the intraoperative hemorrhage and postoperative sequelae (pain, lip numbness, and TMJ symptoms). In addition, neither symptom was significantly correlated with the amount of mandibular setback.
Highlights
Orthognathic surgery, which includes several procedures of varying complexity requiring high surgical skill, demands that surgeons consider multiple variables, such as the patient’s overall physical condition, operating time, intraoperative hemorrhage, postoperative pain, and potential postoperative sequelae and complications
The surgical duration and hemorrhage volume were recorded in all 80 patients, the change in the preand postoperative lip sensation was recorded in 69 patients (42 women and 27 men), the postoperative pain in Visual Analogue Scale (VAS) scores during hospitalization in 47 patients (28 women and 19 men), and the change between the pre- and postoperative maximum mouth opening (MMO) and temporomandibular joint (TMJ) clicking symptoms in 32 patients (22 women and 10 men)
The operating time, volume of intraoperative hemorrhage, and the change between the pre- and postoperative blood components, pain in VAS (0–10 cm), postoperative lip sensation, TMJ clicking, and MMO were recorded during hospitalization
Summary
Orthognathic surgery, which includes several procedures of varying complexity requiring high surgical skill, demands that surgeons consider multiple variables, such as the patient’s overall physical condition, operating time, intraoperative hemorrhage, postoperative pain, and potential postoperative sequelae and complications. For the correction of mandibular prognathism, several improvements in orthognathic surgery have emerged, with sagittal split ramus osteotomy (SSRO) and intraoral vertical ramus osteotomy (IVRO) being among the most popular of the current techniques. These two surgical methods differ in the operating time, hemorrhage volume, and the risk of postoperative sequelae and complications.
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