Journal of clinical and experimental dentistry · 2024
Facial palsy after orthognathic surgery: An integrative analysis of literature reports and an illustrative case.
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Faro Tatiane Fonseca, Silva Joana de Ângelis Alves, Campos Gustavo José de Luna, Queiroz Maristela, Studart-Pereira Luciana Moraes, de Lucena Caroline Vieira, Filho José Rodrigues Laureano
Аннотация
BACKGROUND: To describe a case of a patient with PFP after orthognathic surgery and discuss cases reports on temporary or permanent facial paralysis, factors that trigger injury, and treatment for facial paralysis associated with orthognathic surgery.
MATERIAL AND METHODS: This study has two parts: a report of the case of a 20- year-old man who underwent orthognathic surgery for facial paralysis, and an integrative literature review on postoperative facial paralysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statements and performed survival analyses of all cases reported to date.
RESULTS: The analysis was composed of 33 patients; 54,5% were male (mean age, 25 years). The right side was most affected by PFP (54.5%). Mandibular (48.5%) and bimaxillary (36.4%) surgeries were the most frequently performed procedures; the mandibular movements ranged from 1 to 18 mm (right side) and 2 to 18 mm (left side). The hypotheses regarding the possible causes of PFP differed between the selected studies. However, compression of the facial nerves was the most common. The use of steroids and physiotherapy were the most described treatment plans. The follow-up period ranged from 1.5 to 36 months (average, 6.12 months), and 78.7% of the patients had complete remission.
CONCLUSIONS: Although rare, PFP after orthognathic surgery is one of the most serious complications, as it reduces the quality of life and social interaction of the patients. Therefore, early evaluation should be considered immediately in the postoperative period in patients undergoing orthognathic surgery. There presently is no consensus on the management protocol and establishing a systematization can be beneficial for patients with PFP. Key words:Facial palsy, facial paralysis, sagittal split ramus osteotomy, orthognathic surgery, complication, nerve damage.
MATERIAL AND METHODS: This study has two parts: a report of the case of a 20- year-old man who underwent orthognathic surgery for facial paralysis, and an integrative literature review on postoperative facial paralysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statements and performed survival analyses of all cases reported to date.
RESULTS: The analysis was composed of 33 patients; 54,5% were male (mean age, 25 years). The right side was most affected by PFP (54.5%). Mandibular (48.5%) and bimaxillary (36.4%) surgeries were the most frequently performed procedures; the mandibular movements ranged from 1 to 18 mm (right side) and 2 to 18 mm (left side). The hypotheses regarding the possible causes of PFP differed between the selected studies. However, compression of the facial nerves was the most common. The use of steroids and physiotherapy were the most described treatment plans. The follow-up period ranged from 1.5 to 36 months (average, 6.12 months), and 78.7% of the patients had complete remission.
CONCLUSIONS: Although rare, PFP after orthognathic surgery is one of the most serious complications, as it reduces the quality of life and social interaction of the patients. Therefore, early evaluation should be considered immediately in the postoperative period in patients undergoing orthognathic surgery. There presently is no consensus on the management protocol and establishing a systematization can be beneficial for patients with PFP. Key words:Facial palsy, facial paralysis, sagittal split ramus osteotomy, orthognathic surgery, complication, nerve damage.