Orthognathic surgery in COVID-19 times, is it safe?

Glen, Paul; Aurora, Fabienne; Thomas, Steve; Kissun, Dean

doi:10.1016/j.bjoms.2021.01.005

Cited by 5 publications

(3 citation statements)

References 5 publications

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“…Our findings are consistent with the current body of evidence. While Olate et al and Glen et al also documented no deaths associated with OS, Ferri et al and Bacos et al reported complication rates of 1.5% and 4.5%, respectively [ 20 , 32 , 33 , 34 ]. Notably, during the 30-day postoperative follow-up, no case of pulmonary embolism, unplanned reintubation, prolonged ventilator dependence, renal disorder, cerebral vascular accident, cardiac infarction/arrest, or sepsis/septic shock has been reported.…”

Section: Discussionmentioning

confidence: 99%

Early Outcomes and Risk Factors in Orthognathic Surgery for Mandibular and Maxillary Hypo- and Hyperplasia: A 13-Year Analysis of a Multi-Institutional Database

Knoedler

Baecher

Hoch

et al. 2023

JCM

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Background: Orthognathic surgery (OS) is a frequently performed procedure for the correction of dentofacial deformities and malocclusion. Research on OS is mostly limited to single-surgeon experience or single-institutional reports. We, therefore, retrospectively analyzed a multi-institutional database to investigate outcomes of OS and identify risk factors for peri- and postoperative complications. Methods: We reviewed the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database (2008–2020) to identify patients who underwent OS for mandibular and maxillary hypo- and hyperplasia. The postoperative outcomes of interest included 30-day surgical and medical complications, reoperation, readmission, and mortality. We also evaluated risk factors for complications. Results: The study population included 674 patients, 48% of whom underwent single jaw surgery, 40% double jaw surgery, and 5.5% triple jaw surgery. The average age was 29 ± 11 years, with an equal gender distribution (females: n = 336; 50%, males: n = 338; 50%). Adverse events were relatively rare, with a total of 29 (4.3%) complications reported. The most common surgical complication was superficial incisional infection (n = 14; 2.1%). While the multivariable analysis revealed isolated single lower jaw surgery (p = 0.03) to be independently associated with surgical complication occurrence, it also identified an association between the outpatient setting and the frequency of surgical complications (p = 0.03) and readmissions (p = 0.02). In addition, Asian ethnicity was identified as a risk factor for bleeding (p = 0.003) and readmission (p = 0.0009). Conclusion: Based on the information recorded by the ACS-NSQIP database, our analysis underscored the positive (short-term) safety profile of OS. We found OS of the mandible to be associated with higher complication rates. The calculated risk role of OS in the outpatient setting warrants further investigation. A significant correlation between Asian OS patients and postoperative adverse events was found. Implementation of these novel risk factors into the surgical workflow may help facial surgeons refine their patient selection and improve patient outcomes. Future studies are needed to investigate the causal relationships of the observed statistical correlations.

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Section: Discussionmentioning

confidence: 99%

Early Outcomes and Risk Factors in Orthognathic Surgery for Mandibular and Maxillary Hypo- and Hyperplasia: A 13-Year Analysis of a Multi-Institutional Database

Knoedler

Baecher

Hoch

et al. 2023

JCM

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“…No patients were diagnosed with COVID-19 pre-operatively and none had developed COVID-19 30 days postoperatively. [18] At this time there was no approved vaccine in use. Pre-operative-testing, isolation and infection control procedures were the only precautions utilised.…”

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 pandemic on orthognathic patients: What have we learned?

Wemyss

Benington

Chung

et al. 2022

British Journal of Oral and Maxillofacial Surgery

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Background Due to the COVID-19 pandemic orthognathic surgery was suspended in the UK. The effect this had on patients, to date, is unknown. Aim: A multi-centre, cross-sectional survey was conducted in the UK to investigate the health-related impact for patients on the orthognathic surgery pathway, including those on the waiting list for surgery . Method : A structured questionnaire was designed to explore the impact of the pandemic on the patients whose orthognathic treatment was temporarily cancelled. Results: Ninety-five questionnaires were returned giving a response rate of 65%. When asked if the delay due to the pandemic had caused emotional distress, 63% (51/81) agreed. Respondents experienced more distress, in relation to dental appearance (60%, 51/83), self-confidence (52% 50/83), facial appearance (53%, 44/83) and ability to eat and chew (59%, 50/83) during the pandemic. One hundred percent of patients would have had appliances fitted or their appliances adjusted during the pandemic and 93% percent of patients stated that they would attend for surgery if they were offered this during the pandemic. In conclusion, patients appear to have experienced emotional distress in relation to the delay with their orthognathic treatment. The patients should be given greater priority, during the remobilisation of elective surgery. They should have access to ongoing psychological support, where delays affect their treatment. The “surgery-first” approach may be considered, for suitable patients, to minimise the duration of the treatment journey.

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“…We read with interest the paper by Glen et al 1 They undertook orthognathic surgery at a non NHS hospital following strict protocols and demonstrated that this can be done safely. Nevertheless, such ‘off site’ hospitals do not generally treat COVID patients and hence the risk of hospital acquired COVID infection is less.…”

mentioning

confidence: 99%