Maxillary sinus haziness and facial swelling following suction drainage in the maxilla after orthognathic surgery

Jung-Soo Lee,Sang-Hoon Kang,Moon-Key Kim

doi:10.1186/s40902-020-00277-0

Abstract

BackgroundWe investigated the efficacy of a maxillary Jackson-Pratt (J-P) suction drain for preventing maxillary sinus hematoma and facial swelling after maxillary Le Fort I osteotomy (LF1).MethodsWe retrospectively evaluated 66 patients who underwent LF1 at a single institution. Of these, 41 had a J-P suction tube inserted in the mandible and maxilla (maxillary insertion), and 25 had a J-P drain inserted in the mandible only (no maxillary insertion). Facial CT was obtained before and 4 days after surgery. We compared mean midfacial swelling and maxillary sinus haziness by t test and examined correlations between bleeding amount and body mass index (BMI).ResultsFor the maxillary-insertion group, the ratio of total maxillary sinus volume to haziness (57.5 ± 24.2%) was significantly lower than in the group without maxillary drain insertion (65.5% ± 20.3; P = .043). This latter group, however, did not have a significantly greater midfacial soft tissue volume (7575 mm3) than the maxillary-insertion group (7250 mm3; P = .728). BMI did not correlate significantly with bleeding amount or facial swelling.ConclusionsSuction drainage in the maxilla reduced maxillary sinus haziness after orthognathic surgery but did not significantly reduce midfacial swelling.

Highlights

We investigated the efficacy of a maxillary Jackson-Pratt (J-P) suction drain for preventing maxillary sinus hematoma and facial swelling after maxillary Le Fort I osteotomy (LF1)
Because few studies have examined this question, we investigated the efficacy of a suction drain inserted in the maxilla for preventing postoperative hematoma of the maxillary sinus and facial swelling following a maxillary Le Fort I osteotomy during orthognathic surgery
The mean body mass index (BMI) (±Standard deviation (SD)) of the 41 patients with a maxillary J-P suction tube was 22.8 ± 3.3 kg/m2, and the mean (±SD) amount of blood drained in the 2 days after surgery was 224.8 ± 102.0 mL

Summary

Introduction

We investigated the efficacy of a maxillary Jackson-Pratt (J-P) suction drain for preventing maxillary sinus hematoma and facial swelling after maxillary Le Fort I osteotomy (LF1). Postoperative complications of orthognathic surgery include bleeding, respiratory disorder, postoperative pain, soft tissue swelling, inflammatory reactions, infection, nausea, and vomiting [1]. During a Le Fort I osteotomy, bone cuts are made in the maxillary sinus, which can result in maxillary sinus changes and bleeding [2]. The bleeding around the maxilla following a Le Fort I osteotomy needs to be reduced as much as possible to Postoperative midfacial swelling needs to be considered after orthognathic surgery, which results in temporary swelling whether it is single or double jaw or performed on the maxilla or mandible. Extensive research has targeted potential ways to reduce postoperative swelling, and basic methods include cooling the surgical anatomic area and administering corticosteroids [5, 6]

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