Retrospective examination of complications observed in orthognathic surgical surgery in 85 patients

BACKGROUND: The aim of our study is to examine the possible complications, risk factors, and solutions encountered in orthog-nathic surgery in the light of the cases; we performed in our clinic.
METHODS: This study includes a retrospective analysis of the records of 85 patients who underwent orthognathic surgery between 2015 and 2020 in Istanbul Pendik District Hospital Oral and Maxillofacial Surgery Service. The types of complications encountered during the operations were recorded in the study. Independent variables such as gender, age, number of operations, surgical site, and type of osteotomy were evaluated. Complications were evaluated according to the Clavien–Dindo classification. The data were pre-sented for statistical analysis with a significance level of 0.05.
RESULTS: Of the 85 patients included in the study, 40 were male and 45 were female. Of these patients, 65 had double chin operation and 20 had single chin operation. A total of 150 jaw osteotomies were performed, 78 of them in the maxilla and 72 in the mandible. While the maxilla was operated in 13 of the cases, in which single jaw operation was performed, only the mandible was treated in 7 of them. Complications were observed in 24 (10.57%) of a total of 227 osteotomies. Among the complications encountered, bleeding (8), nerve damage (7), malocclusion (3), infection (2), TMJ problems (2), bad split (1), and deviation at the tip of the nose (1) stand out, while complications were observed equally in men and women, complications were observed more frequently in cases with longer operative time (p<0.05). Complications were observed more frequently in bilateral sagittal split osteotomies (p<0.001) compared to Le Fort 1 osteotomies. Clavien–Dindo grade I complications were most common (72.04%) depending on the treatment. According to the Clavien–Dindo classification, there was no relationship between gender, age, duration of surgery, length of hospital stay, or surgical site, and the degree of complications (p≥0.05).
CONCLUSION: Post-operative malocclusion, bleeding, inferior alveolar nerve injury, infection, poor division, and infection are the most common complications in orthognathic surgery. It can be associated with factors such as the duration of the operation, the number of operations, the site of the operation, and the type of osteotomy which performed. It is thought that positive contributions can be made to the success of the surgery by considering these factors in the treatment planning, during the operation and in the post-operative follow-up part.

85 hastada yapýlan ortognatik cerrahi ameliyatlarýnda gözlenen komplikasyonlarýn geriye dönük incelenmesi

AMAÇ: Çalýþmamýzýn amacý kliniðimizde yaptýðýmýz olgular ýþýðýnda ortognatik cerrahide karþýlaþýlan muhtemel komplikasyonlarý, risk faktörlerini ve çözümlerini incelemektir.
GEREÇ VE YÖNTEM: Bu çalýþmada Ýstanbul Pendik Bölge Hastanesi Aðýz, Diþ ve Çene Cerrahisi Servisinde 2015 ve 2020 yýllarý arasýnda ortognatik cerrahi uygulanan 85 hastanýn kayýtlarýnýn geriye dönük olarak incelenmesini kapsamaktadýr. Çalýþmada operasyonlarda karþýlaþýlan komplikasyon tipleri kaydedildi. Cinsiyet, yaþ, ameliyat sayýsý, ameliyat yeri ve yapýlan osteotomi tipi gibi baðýmsýz deðiþkenler deðerlendirildi. Komplikasyonlar Clavien-Dindo Sýnýflamasýna göre incelendi. Veriler anlamlýlýk düzeyi 0.05 ile istatistiksel analize sunuldu.
BULGULAR: Çalýþmaya dahil olan 85 hastanýn 40’ý erkek, 45’i kadýndýr. Bu hastalarýn 65’ine çift çene operasyonu, 20’sine tek çene operasyonu yapýlmýþtýr. Toplamda 150 adet çene osteotomisi uygulanmýþ olup, bunlarýn 78 tanesi maksillada, 72 tanesi mandibuladadýr. Tek çene operasyonu yapýlan vakalarýn 13’ünde maksillada iþlem yapýlmýþ iken, yedisinde sadece mandibula iþlem görmüþtür. Toplam 227 osteotomiden 24’ünde (%10.57) komplikasyon gözlenmiþtir. Karþýlaþýlan komplikasyonlar arasýnda kanama (8), sinir hasarý (7), maloklüzyon (3), enfeksiyon (2), TME problemleri (2), bad split (1) ve burun ucunda deviasyon (1) göze çarpmaktadýr. Komplikasyonlar kadýn ve erkeklerde eþit olarak gözlenirken, ameliyat süresi uzayan olgularda daha sýk komplikasyon gözlenmiþtir (p<0.05). Ýki taraflý sagital split osteotomilerde (p<0.001) komplikasyonlar Le Fort 1 osteotomilerine göre daha sýk gözlendi. Tedaviye baðlý olarak en sýk (%72.04) Clavien-Dindo derece I komplikasyonlarý görüldü. Clavien-Dindo sýnýflamasýna göre cinsiyet, yaþ, ameliyat süresi, hastanede kalýþ süresi veya cerrahi bölge arasýnda komplikasyon dereceleri arasýnda bir iliþki yoktu (p≥0.05). TARTIÞMA: Ortognatik cerrahide ameliyat sonrasý maloklüzyon, kanama, inferior alveolar sinir yaralanmasý, enfeksiyon, kötü bölünme ve enfek-siyon en sýk görülen komplikasyonlardýr. Komplikasyonlar; ameliyat süresi, ameliyat sayýsý, ameliyat yeri ve yapýlan osteotomi tipi gibi faktörlerle iliþkilendirebilmektedir. Tedavi planlamasýnda, ameliyat esnasýnda ve ameliyat sonrasý takip kýsmýnda bu faktörlerde göz önünde bulundurularak ameliyatýn baþarýsýna olumlu katkýlar saðlanabileceði düþünülmektedir.