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正颌手术后的并发症:我们对423例病例的经验。

Complications after orthognathic surgery: our experience on 423 cases.

作者信息

Friscia Marco, Sbordone Carolina, Petrocelli Marzia, Vaira Luigi Angelo, Attanasi Federica, Cassandro Francesco Maria, Paternoster Mariano, Iaconetta Giorgio, Califano Luigi

机构信息

Department of Maxillo-Facial Surgery, School of Medicine, University of Naples "Federico II", Via S. Pansini 5, 80100, Naples, Italy.

Statistical Science Department, School of Statistic Science, University of Rome "La Sapienza", Piazzale Aldo Moro 5, 00185, Rome, Italy.

出版信息

Oral Maxillofac Surg. 2017 Jun;21(2):171-177. doi: 10.1007/s10006-017-0614-5. Epub 2017 Mar 2.

Abstract

INTRODUCTION

Orthognathic surgery is widely used to correct dentofacial discrepancies. However, this procedure presents numerous possible complications. The aim of our study is to review intraoperative and postoperative complications related to orthognathic surgery based upon a 10-year period in the Maxillofacial Surgery Department of Federico II University of Naples.

MATERIALS AND METHODS

Medical records of 423 patients who undergone orthognathic surgery in a 10-year period were retrospectively analyzed and complications was noted. Statistical analysis was conduced in order to understand if the type of surgical procedure influenced complications rate.

RESULTS

One hundred eighty-five complications in 143 (33.8%) of the 423 treated patients were reported. Complications detected were nerve injury (49 cases, 11.9%), infections (10 cases, 2.4%), complications related to fixation plates or screws (30 cases, 7.1%), bad split osteotomy (8 cases, 1.9%), secondary temporo-mandibular joint disorders (36 cases, 8.5%), dental injuries (21 cases, 5%), condilar resorption (2 cases, 0.5%), and necessity of a second-time surgery (24 cases, 5.7%).

CONCLUSIONS

Serious complications seem to be quite rare in orthognathic surgery. Some of the surgical complications found are related to the surgeon experience and not strictly to the risks of the operation itself. Understanding potential complications allows the surgeon to guarantee safe care through early intervention and correctly inform the patient in the preoperative colloquy.

摘要

引言

正颌外科手术被广泛用于矫正牙颌面畸形。然而,该手术存在众多可能的并发症。我们研究的目的是基于那不勒斯费德里科二世大学颌面外科10年的数据,回顾与正颌外科手术相关的术中及术后并发症。

材料与方法

回顾性分析了423例在10年内接受正颌外科手术患者的病历,并记录并发症情况。进行统计分析以了解手术方式是否会影响并发症发生率。

结果

在423例接受治疗的患者中,143例(33.8%)出现了185例并发症。检测到的并发症包括神经损伤(49例,11.9%)、感染(10例,2.4%)、与固定板或螺钉相关的并发症(30例,7.1%)、截骨裂开不良(8例,1.9%)、继发性颞下颌关节紊乱(36例,8.5%)、牙齿损伤(21例,5%)、髁突吸收(2例,0.5%)以及二次手术的必要性(24例,5.7%)。

结论

正颌外科手术中严重并发症似乎相当罕见。所发现的一些手术并发症与外科医生的经验有关,而并非严格取决于手术本身的风险。了解潜在并发症能让外科医生通过早期干预确保安全治疗,并在术前谈话中正确告知患者。

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