Facial nerve palsy following bilateral sagittal split ramus osteotomy for setback of the mandible

Ruiz, Laura Pacheco; Lara, J. Chaurand

doi:10.1016/j.ijom.2011.02.030

Cited by 18 publications

(10 citation statements)

References 9 publications

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“…14 Unless the surgeon suspects direct nerve transection, surgical exploration for the facial nerve is not indicated. 29 In this study, 88.9% of the patients attained full recovery with the median duration of 3 months (IQR, 2.75 to 6 months; range, 1 to 22 months) postoperatively. This full recovery rate seems higher than our previous literature review, where 79.6% of the patients recovered fully, with the mean duration of 3.6 ± 2.6 months (range, 0.5 to 12 months).…”

Section: Discussionmentioning

confidence: 58%

Facial palsy after orthognathic surgery: Incidence, causative mechanism, management, and outcome

Hattori¹,

Huang²,

Chang³

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Background: Facial palsy after orthognathic surgery is an uncommon but serious complication causing dissatisfaction and affecting quality of life. The occurrence could be underreported. Surgeons need to recognize this issue regarding the incidence, causative mechanism, managements, and outcome. Methods: A retrospective review of orthognathic surgery records between January of 1981 and May of 2022 was conducted in the authors' craniofacial center. Patients who developed facial palsy after the surgery were identified, and demographics, surgical methods, radiologic images, and photographs were collected. Results: A total of 20,953 sagittal split ramus osteotomies (SSROs) were performed in 10,478 patients. Twenty-seven patients developed facial palsy, resulting in an incidence of 0.13% per SSRO. In a comparison of SSRO technique, the Obwegeser-Dal Pont technique using osteotome for splitting had higher risk of facial palsy than the Hunsuck technique using the manual twist splitting (P < 0.05). The severity of facial palsy was complete in 55.6% of patients and incomplete in 44.4%. All patients were treated conservatively, and 88.9% attained full recovery in a median duration of 3 months [interquartile range (IQR), 2.75 to 6 months] after surgery, whereas 11.1% attained partial recovery. Initial severity of facial palsy predicted the timing of recovery, with incomplete palsy patients having faster median recovery (3 months; IQR, 2 to 3 months) than the complete palsy patients (6 months; IQR, 4 to 6.25 months) (P = 0.02). Conclusions: The incidence of facial palsy after orthognathic surgery was 0.13%. Intraoperative nerve compression was the most likely causative mechanism. Conservative treatment is the mainstay of therapeutic strategy, and full functional recovery was anticipated.

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Section: Discussionmentioning

confidence: 58%

Facial palsy after orthognathic surgery: Incidence, causative mechanism, management, and outcome

Hattori¹,

Huang²,

Chang³

et al. 2023

Plastic &Amp; Reconstructive Surgery

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“…The use of drug therapy except nimodipine, combined with physical therapy, showed no major difference, with an average recovery time of 16.32 weeks. The recovery time of 10 weeks in the present study was slightly faster ( Table 1 ) [ 4 10 11 12 13 14 ]. Moreover, there were no complications from nimodipine administration.…”

Section: Case Reportmentioning

confidence: 79%

“…Accordingly, the authors of the present study examined recovery in post-MSSRO patients with FNP who were prescribed nimodipine (Nimotop 30 mg Tablets, Bayer AG, Germany), a calcium antagonist vasodilator, and compared the results to literature reports on recovery in patients who did not use nimodipine; the patients treated with nimodipine showed slightly faster recovery [ 4 8 9 10 11 12 13 ].…”

Section: Introductionmentioning

confidence: 99%

New Treatment in Facial Nerve Palsy Caused by Sagittal Split Ramus Osteotomy of Mandible

Lee

2017

Arch Craniofac Surg

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A 25-years-old woman with mandibular prognathism underwent a mandibular setback by way of mandibular sagittal split ramus osteotomy (MSSRO). After 2 days of operation, she developed difficulty of closing her right eye. The blink reflex test and motor nerve conduction study of the right orbicularis oris muscle were revealed right facial neuropathy of unknown origin and House-Brackmann facial nerve grading system (HBFNGS) grade V. For treatment, we initially prescribed oral prednisolone and nimodipine including physical therapy. The samples consisted of 11 facial nerve palsy patients caused by MSSRO and were analysed about onset of facial nerve palsy, postoperative HBFNGS, final HBFNGS, treatment method and recovery time. At 10 weeks of treatment of nimodipine, she had completely regained normal function (HBFNGS grade I) of the right facial nerve. The clinical results lead to assume a fast recovery of facial nerve function by the nimodipine medication, whereas average time of recovery is 16.32 weeks in references. Despite of the limited one patient treated, the result was very promising with respect to a faster recovery of the facial nerve function. Considering the use of nimodipine treatment for peripheral facial nerve palsy following a surgical approach with an anatomically preserved nerve can be recommended.

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“…The surgical techniques that have evolved over recent decades now allow for almost any type of repositioning within the facial bone structure. Orthognathic surgeries (OGS) may concern a single jaw, either maxilla (Le Fort I type osteotomy) or mandible (bilateral sagittal split osteotomy—BSSO), or both jaws, when both techniques are combined during one procedure [ 1 , 2 ]. OGS is frequently used to correct skeletal classes II and III deformities, dentofacial maxillary deformities, mandibular laterognathism, and maxillofacial asymmetry [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Physiotherapeutic Reduction of Orofacial Pain Using Extremely Low-Frequency Electromagnetic Field and Light-Emitting Diode Therapy—A Pilot Study

Lietz–Kijak

Ardan

2022

Pain Research and Management

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Introduction. Pain is a natural response of the body to injury and one of the symptoms defining an inflammatory reaction. It is almost always present after orthognathic surgeries (OGS), but its severity is subjective in each patient. Postoperative care of the patient is aimed at minimizing of postoperative pain relief orofacial region. Options of physiotherapy include extremely low-frequency electromagnetic field (ELF EMF) and high-energy light-emitting diode (LED). Aim of the Study. The aim of this study was to evaluate the effects of physiotherapy combining ELF EMF and LED to reduce pain of the orofacial region in patients after OGS. Material and Methods. The study was conducted in thirty-two patients who underwent OGS to treat morphological defects. The participants were randomly divided into two groups: Physiotherapy group (PT) and Control group (CG). In both groups, patients were prescribed Paracetamol and nonsteroidal analgesics (NSAID—ibuprofen). Patients from the PT group additionally received postoperative physiotherapy immediately after leaving the surgical clinic in the form of ELF EMF and LED therapy. Physiotherapeutic treatments were performed for 10 days, three applications a day, at no cost to the patient. Pain intensity was assessed using the visual analogue scale (VAS), which is a reliable instrument for the measurement of pain intensity self-reported by the patient. Results. Faster reduction of pain was the major observation made in patients who received physiotherapy treatments. In all subjects, after 5 days of therapy, the pain intensity was reduced by about 50% or resolved completely. Effects of therapy were measured with the relative changes in the pain intensity score, showing what fraction of the initial pain was eliminated at the first stage and throughout the whole therapy. The analysis of relative changes instead of absolute changes allowed us, among other things, to eliminate the bias of the higher initial pain intensity in the CG group compared to the PT group. Conclusions. The conducted research revealed that the combined use of ELF EMF and LED is beneficial in the reduction of pain of patients after OGS. The analgesic effects of physiotherapy in the treatment after OGS are necessary to continue research in this area and analyze the possibility of extending the indications for its use in other surgically treated maxillofacial diseases.

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Facial nerve palsy following bilateral sagittal split ramus osteotomy for setback of the mandible

Cited by 18 publications

References 9 publications

Facial palsy after orthognathic surgery: Incidence, causative mechanism, management, and outcome

Facial palsy after orthognathic surgery: Incidence, causative mechanism, management, and outcome

New Treatment in Facial Nerve Palsy Caused by Sagittal Split Ramus Osteotomy of Mandible

Physiotherapeutic Reduction of Orofacial Pain Using Extremely Low-Frequency Electromagnetic Field and Light-Emitting Diode Therapy—A Pilot Study

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