Manual lymphatic drainage was effective in reducing facial measurements in orthognathic surgery postoperatory. When considering patient's pain and swelling perception, no difference was found between groups.

This chapter will discuss the expected edema and intercurrences in maxillofacial surgery, which involves important anatomical structures, such as the upper airways. It will also discuss important issues such as intrinsic and extrinsic enhancers of edema and the main consequences of a severe edema setting according to physiological, functional, and psychosocial points of view. Edema assessment and measurement is still performed subjectively in the clinical routine. However, for the accomplishment of studies, more objective forms are being tested, but still not very successful for clinical applicability. It is known that the best way to deal with edema is prevention; so in elective surgeries, much is discussed about the best management forms. This way, besides edema prevention, it is important not to cause unwanted reactions for the patient or in the performed procedure. Therefore, it will also be debated about preoperative medications and their consequences. Another point discussed involves main treatments for the underdeveloping edema and the one already installed, such as manual lymphatic drainage therapy, a treatment that is well known and used in other specialties, but is still very little widespread among maxillofacial surgeons.

DEDICATÓRIAA Deus, pelo dom da vida, por sempre guiar os meus passos e acalmar o meu coração! A minha mãezinha do céu, Maria, a quem recorri e recorro tantas vezes! Ao amor da minha vida, meu marido Cirsyano Sandim da Silveira, pelo amor, respeito, carinho, amizade, paciência, por acreditar em mim e por suprir minhas ausências com nossa filha Isadora durante a realização deste trabalho.A minha filha Isadora Zabotini da Silveira, razão do meu viver, com quem pude aprender verdadeiramente o sentido do amor incondicional! Aos meus pais Isnard Zabotini e Maria de Lurdes Specian Zabotini pelo amor incondicional, pelo exemplo de vida honesta e digna, pelo apoio constante durante toda a minha vida e minhas escolhas e por serem meu porto seguro! Ao meu irmão Marcelo Specian Zabotini, pelo amor, amizade, companheirismo e exemplo de profissional que é! Você sempre me inspira a ir adiante! A vocês meu amor incondicional e minha gratidão! AGRADECIMENTOS ESPECIAISA minha querida amiga Ana Carolina Bonetti Valente, pelo carinho, afeto, paciência, risadas e choros, por estar ao meu lado e me apoiar em todos os momentos. Sua ajuda foi essencial na realização deste trabalho.Ao meu orientador Dr Renato Yassutaka Faria Yaedú, pela oportunidade, disponibilidade, acolhimento, competência e paciência em me ensinar, e por ser um exemplo de profissional. A vocês meu muito obrigada e minha eterna gratidão! AGRADECIMENTOSA minha grande amiga e fisioterapeuta Talita Gomes Torres De Conti, pela amizade, carinho, paciência, compreensão, ajuda na coleta de dados e apoio em todos os momentos desta pesquisa. Significou muito para mim! Às amigas e fisioterapeutas do HRAC/USP Ineida Maria Bachega Lopes, KarineAparecida Arruda e Vanessa Langelli Antunes pela amizade, paciência, trocas de horários de trabalho e compreensão durante toda a realização deste trabalho.Saibam que foi importante ter vocês ao meu lado! À Luiza Souza Bucvik, pela amizade, empatia e carinho desde o dia em que nos conhecemos! À Tatiana Casoto, pela amizade, por me apoiar e me escutar sempre que precisei! À amiga Maria Júlia Costa de Souza, médica maravilhosa, humilde e de um coração enorme, que sempre me incentivou a continuar.Aos amigos de trabalho do HRAC/USP, em especial Daniele

It is believed that the use of the nasopharyngeal cannula can maintain the patent upper airway in the immediate post-operative period of orthognathic surgery. The present study is a randomized clinical trial with the objective of evaluating the difference in the use of the nasopharyngeal cannula in the post-operative period of orthognathic surgery with respect to permeability and discomfort. The sample was composed of 26 individuals with repaired cleft lip and palate randomly distributed in 2 groups with and without nasopharyngeal cannula. The evaluation was composed by Visual Analogue Scale (VAS), test with Altman mirror in 4 pre-operative periods, 6, 24, 30 hours after the operation. Rhinomanometry was also performed, a flow- pressure technique in 2 distinct moments, 6 and 24 hours after surgery. As a result, greater discomfort, greater obstruction as well as a reduction in the area of bilateral minimum nasal cross-section (ASTM) and increased resistance in the group with nasopharyngeal cannula are observed. In the intra-group comparison with the lowest ASTM values, the test group showed a significant difference between the first and the second moments (P = 0.001). It can be concluded that the nasopharyngeal cannula contributes to increase discomfort, worsens airway permeability by decreasing ASTM and increasing nasal resistance. Regarding the length of stay of the nasopharyngeal cannula, it can be said that from 6 hours onwards it does not contribute to the reduction of discomfort, airway permeability and assist in hemostasis.