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Method of osteotomy fixation and need for removal following bimaxillary orthognathic, osseous genioplasty, and intranasal surgery: a retrospective cohort study.

Abstract
The purpose of this study was to determine the incidence and causes of fixation hardware removal after bimaxillary orthognathic, osseous genioplasty, and intranasal surgery. A retrospective study was performed, involving subjects with a bimaxillary developmental dentofacial deformity (DFD) and symptomatic chronic obstructive nasal breathing. At a minimum, subjects underwent Le Fort I osteotomy, bilateral sagittal ramus osteotomies (SROs), septoplasty, inferior turbinate reduction, and osseous genioplasty. The primary outcome variable studied was fixation hardware removal. Demographic, anatomical, and surgical predictor variables were assessed. Two hundred sixty-two subjects met the inclusion criteria. Their mean age at operation was 25 years (range 13-63 years); 134 were female (51.1%). Simultaneous removal of a third molar was performed in 39.9% of SROs. Three of 262 Le Fort I procedures (1.1%) and two of 524 SROs (0.4%) required hardware removal. There were four cases of ramus wound dehiscence, four of ramus surgical site infection (SSI), one of chin SSI, two of maxillary sinusitis, and one of lingual nerve injury; none of these subjects underwent hardware removal. A limited need for fixation hardware removal after orthognathic procedures was confirmed. There was no statistical correlation between hardware removal and patient sex, age, pattern of DFD, simultaneous removal of a third molar, or occurrence of wound dehiscence, SSI, or lingual nerve injury.
AuthorsJ C Posnick, E Choi, A Chavda
JournalInternational journal of oral and maxillofacial surgery (Int J Oral Maxillofac Surg) Vol. 46 Issue 10 Pg. 1276-1283 (Oct 2017) ISSN: 1399-0020 [Electronic] Denmark
PMID28669486 (Publication Type: Journal Article)
CopyrightCopyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Topics
  • Adolescent
  • Adult
  • Dentofacial Deformities (surgery)
  • Device Removal
  • Female
  • Genioplasty (methods)
  • Humans
  • Internal Fixators
  • Male
  • Middle Aged
  • Molar, Third (surgery)
  • Nasal Obstruction (surgery)
  • Nasal Septum (surgery)
  • Osteotomy, Le Fort
  • Osteotomy, Sagittal Split Ramus
  • Postoperative Complications (epidemiology)
  • Retrospective Studies
  • Treatment Outcome
  • Turbinates (surgery)

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