Pediatric Orthognathic Surgery: National Analysis of Perioperative Complications

Abstract

cantholysis can be performed to reduce intraorbital pressure and to minimize the risk of vision loss. It is then characterized as a medical emergency, because it can lead to blindness or other life-threatening complications if not treated promptly. [21][22][23] Therefore, the clinical presentation of our patient demanded an early surgical intervention.It is not clear whether SARS-CoV-2 itself is a contributing factor to the pathogenesis in these cases. However, the time of onset and the absence of previous symptoms of chronic sinus disease raises the possibility that congestion of the upper secondary airway by COVID-19 contributed to impaired mucociliary clearance, sinus obstruction, and secondary orbital bacterial infection. Health professionals involved in the care of COVID 19 cases should be aware of this unusual presentation.

National Trends in Orthognathic Surgery: A Multi-Institutional Analysis of 6640 Patients

“…Infections were significantly more prevalent in LF1 than BSSO procedures ( P <0.001). On the basis of the studies on adults and children, infections after orthognathic surgery have been reported to range from 1.1% to 33.4% 11,33–36 . A previous multicenter study demonstrated that pediatric patients overall experience infection at a rate of 1.1% after orthognathic surgery 11 .…”

“…Several multi-institutional database studies have shown that performing orthognathic surgery at high-volume centers results in fewer complications, decreased costs, and shorter lengths of stay 1,8 . Although many of these studies analyzed only adult patients, or adult and pediatric populations together, only 1 nationwide study specifically focused on the outcomes of pediatric patients 11 . That study included pediatric patients of all ages from birth through 18 years of age and was able to elucidate the specific risk factors for patients 6 years and younger.…”

“…Although that data are relevant, it may confound the analysis of adolescent patients undergoing orthognathic procedures, as those treated before skeletal maturity generally have different indications and a higher degree of comorbid conditions. 11 The purpose of this study was to conduct a large-scale, multi-institutional analysis of adolescent and young adult patients undergoing orthognathic surgery after skeletal maturity to elucidate the impact of high-volume centers and certain risk factors on adverse postoperative outcomes. Additional objectives include identifying disparities in access to care based on geographic locations, race, ethnicity, and household income.…”

“…1,8 Although many of these studies analyzed only adult patients, or adult and pediatric populations together, only 1 nationwide study specifically focused on the outcomes of pediatric patients. 11 That study included pediatric patients of all ages from birth through 18 years of age and was able to elucidate the specific risk factors for patients 6 years and younger. Although that data are relevant, it may confound the analysis of adolescent patients undergoing orthognathic procedures, as those treated before skeletal maturity generally have different indications and a higher degree of comorbid conditions.…”

Risk Assessments in Orthognathic Surgery: A National Inpatient Sample (NIS) and Nationwide Ambulatory Surgery Sample (NASS) Analysis

“…4 The consequences of such complications not only affect the patient's quality of life, resulting in increased morbidity and mortality risks, but can also place a significant financial burden on the patient and healthcare system as well. 2,5,[11][12][13][14] Hence, a focused investigation on these outcomes following orthognathic surgery is warranted to direct future efforts to minimize these costs and complications.…”