Frequency and patterns of craniomaxillofacial surgery during and after COVID-19: analysis of the Japanese national database.

PURPOSE: Craniomaxillofacial (CMF) trauma is primarily associated with high-energy injuries and constitutes a significant proportion of hospital presentations in Japan. The coronavirus disease 2019 (COVID-19) pandemic and related public health restrictions profoundly altered daily life and social behavior, potentially influencing trauma patterns and surgical interventions for CMF injuries.

METHODS

We retrospectively analyzed nationwide data from the Japanese National Database, covering the period from 1 January 2014 to 31 December 2023. Inpatient and outpatient CMF surgical procedures were identified using procedural codes and categorized into pre-pandemic (2014–2019), pandemic (2020–2021), and post-pandemic recovery (2022–2023) periods. Statistical analysis included descriptive evaluation and comparative analysis across these periods.

RESULTS

In total, 30,398 CMF surgical procedures were recorded during the 10-year study period. The pre-pandemic period averaged 3,528.0 cases per year, which declined to 2,756.5 cases per year during the pandemic period, representing a 21.87% reduction (p < 0.001). The post-pandemic period showed partial recovery, averaging 3,358.5 cases per year, remaining 4.80% below pre-pandemic levels. The largest pandemic-period declines were observed for bilateral mandibular condylar fracture surgery (− 100%), bilateral mandibular fracture surgery (− 40.5%), and non-invasive reduction of maxillary fractures (− 43.8%). Notable recovery patterns emerged post-pandemic, with zygomatic fracture procedures surpassing pre-pandemic levels (+ 2.7%), while most other procedures remained below baseline.

CONCLUSION

The COVID-19 pandemic significantly reduced CMF surgical procedures in Japan, with differential impacts across procedure types. The post-pandemic period reveals heterogeneous recovery patterns—some procedures exceeding pre-pandemic levels while others persistently lag—suggesting enduring changes in trauma patterns and healthcare utilization.