Evaluation of Complications Associated with Surgically Assisted Rapid Maxillary Expansion in Cases with or Without Pterygomaxillary Disjunction

Abstract

Objective: Surgically assisted rapid maxillary expansion (SARME) is a widely used treatment method for the correction of transversal deficiencies of the maxilla. The gold standard treatment method among various surgical techniques has not been established. This retrospective study aimed to determine complications in SARME cases with and without pterygomaxillary disjunction and evaluate the differences between intraoperative and post-operative complications between the two groups. Materials and Methods: We enrolled 38 patients (25 females and 13 males) who underwent SARME under general anaesthesia at Aydın Adnan Menderes University Faculty of Dentistry between January 2015 and January 2020 in this study. These patients were divided into the following two groups: Patients with pterygomaxillary disjunction group and patients without pterygomaxillary disjunction group. The intraoperative and post-operative complications were evaluated for both the groups. Results: Technically, the pterygoid junction was broken in 17 of the 38 patients included in this study with SARME; however, it was intact in 21 patients. Intraoperative haemorrhage was observed in two patients in the group with pterygomaxillary disjunction and in one patient in the group without pterygomaxillary disjunction. Electrocauterisation was performed to control bleeding in both the groups. In the group with pterygomaxillary disjunction, postoperative hematoma was observed following intraoperative haemorrhage in two patients, post-operative asymmetric expansion in two patients and post-operative unilateral transient paraesthesia in one patient. Conclusion:The most common complication was haemorrhage, which was more observed in the group with pterygomaxillary disjunction. However, asymmetric disjunction was also seen in the group with pterygomaxillary disjunction. Whereas, minor complications were observed in the group without pterygomaxillary disjunction. As a result, the surgical technique, where the pterygoid junction remained intact, has minimal risk for complications.