Influence of maxillomandibular skeletal discrepancy on the position and course of the retromandibular vein in patients with jaw deformities.

INTRODUCTION

The retromandibular vein (RMV) is considered a potential risk for hemorrhage during sagittal split ramus osteotomy (SSRO), depending on its course patterns. This retrospective study investigated the relationship between the course of the RMV and craniofacial morphology in patients with jaw deformities.

MATERIAL AND

METHODS

Forty sides from 20 patients were evaluated using contrast-enhanced computed tomography (CECT) and cephalometric analysis. The RMV courses were classified based on lateral and posterior views of the mandible. Cephalometric and dental cast measurements were compared between groups, and multiple logistic regression was performed to identify the factors influencing the RMV course patterns, with the RMV classification as the dependent variable and cephalometric and model analysis values as the independent variables.

RESULTS

RMVs running posterior to the mandibular ramus were associated with high-angle skeletal patterns, characterized by increased mandibular plane angle and gonial angle (p < 0.05). The lower RMV position showed a significant association with an increased mandibular plane angle and narrow nasal width, tending to run along the posterior border of the mandibular ramus.

DISCUSSION: The findings suggest that vertical skeletal features and mandibular shape, rather than anteoposterior jaw discrepancies, influence RMV positioning. Cephalometric analysis may serve as a practical and non-invasive method for preoperative screening of RMV injury risk, contributing to improved safety in orthognathic surgery.