.: ORİJİNAL ARAŞTIRMA
The Relationship Between Orthognathic Surgery and Anesthesia-Related Complications: A Retrospective Study
Genel Anestezi Altındaki Ortognatik Cerrahi Prosedürlerinin Perioperatif Olarak Değerlendirilmesi: Retrospektif Bir Çalışma
Turkiye Klinikleri J Dental Sci. 2022;28(2):252-9
doi: 10.5336/dentalsci.2021-84069
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: The reconstruction of dentofacial deformities via orthognathic surgery is one of the procedures in oral and maxillofacial surgery. Several complications can occur-related to general anesthesia and prolonged operating time. The aim of this study was to investigate the effect of type of the skeletal deformity and the type of orthognathic surgery on anesthesia-related complications. Two hundred and two patients who underwent orthognathic surgery under general anesthesia were evaluated retrospectively. Material and Methods: According to inclusion criteria, 114 patients were included in the study. The patients were divided into two groups according to their surgical operations as single jaw (n=41) and double jaw (n=73) surgery. Ninety seven patients have skeletal Class 3 deformity and 17 patients have Class 2 deformity. The incidence of intraoperative surgical complications, duration of surgery, intubation difficulty, blood transfusion, postoperative intensive care and/or usage of additional medication were descriptively analyzed. Anesthesia-related complications were statistically compared between the groups. Results: The most common surgery-related complication was bad split. The incidence of life-threatening complications such as extensive blood loss or pulmonary edema was slightly higher in skeletal Class 2 patients and in double jaw surgery group. Although there was no statistically significant difference between the groups, both Mallampati score and difficult intubation scores were higher in skeletal Class 2 groups. Conclusion: Surgeon should be aware of prolonged surgery time can increase the complication risk while anesthesiologist should be aware of the Class 2 skeletal deformity-related intubation difficulties.
Keywords: Orthognathic surgery; complication; general anesthesia; Mallampati score; Cormack Lehane score
Objective: The reconstruction of dentofacial deformities via orthognathic surgery is one of the procedures in oral and maxillofacial surgery. Several complications can occur-related to general anesthesia and prolonged operating time. The aim of this study was to investigate the effect of type of the skeletal deformity and the type of orthognathic surgery on anesthesia-related complications. Two hundred and two patients who underwent orthognathic surgery under general anesthesia were evaluated retrospectively. Material and Methods: According to inclusion criteria, 114 patients were included in the study. The patients were divided into two groups according to their surgical operations as single jaw (n=41) and double jaw (n=73) surgery. Ninety seven patients have skeletal Class 3 deformity and 17 patients have Class 2 deformity. The incidence of intraoperative surgical complications, duration of surgery, intubation difficulty, blood transfusion, postoperative intensive care and/or usage of additional medication were descriptively analyzed. Anesthesia-related complications were statistically compared between the groups. Results: The most common surgery-related complication was bad split. The incidence of life-threatening complications such as extensive blood loss or pulmonary edema was slightly higher in skeletal Class 2 patients and in double jaw surgery group. Although there was no statistically significant difference between the groups, both Mallampati score and difficult intubation scores were higher in skeletal Class 2 groups. Conclusion: Surgeon should be aware of prolonged surgery time can increase the complication risk while anesthesiologist should be aware of the Class 2 skeletal deformity-related intubation difficulties.
Keywords: Orthognathic surgery; complication; general anesthesia; Mallampati score; Cormack Lehane score
ÖZET
Amaç: Ortognatik cerrahi ile dentofasiyal deformitelerin rekonstrüksiyonu ağız diş ve çene cerrahisi bölümünde en sık uygulanan işlemlerden birisidir. Genel anestezi ve ameliyat süresinin uzamasına bağlı olarak çeşitli komplikasyonlar ortaya çıkabilir. Bu çalışmanın amacı, iskeletsel deformitenin tipi ve ortognatik cerrahi tipinin anesteziye bağlı komplikasyonlara etkisini araştırmaktır. Genel anestezi altında ortognatik cerrahi uygulanan 202 hasta retrospektif olarak değerlendirilmiştir. Gereç ve Yöntemler: Yüz on dört hasta çalışmaya dâhil edildi. Hastalar cerrahi operasyonlarına göre tek çene (n=41) ve çift çene (n=73) cerrahi olarak 2 gruba ayrıldı. Doksan yedi hastada iskeletsel Sınıf 3 deformite ve 17 hastada Sınıf 2 deformite vardı. İntraoperatif cerrahi komplikasyon insidansı, cerrahinin süresi, entübasyon zorluğu, kan transfüzyonu, postoperatif yoğun bakım ihtiyacı ve/veya ek ilaç kullanımı analiz edildi. Anesteziye bağlı komplikasyonlar, gruplar arasında istatistiksel olarak karşılaştırıldı. Bulgular: Cerrahiye bağlı en yaygın komplikasyon 'bad' split olarak belirtilmiştir. Yaygın kan kaybı veya akciğer ödemi gibi hayatı tehdit eden komplikasyonların insidansı, iskeletsel Sınıf 2 hastalarda ve çift çene cerrahisi grubunda biraz daha yüksekti. Gruplar arasında istatistiksel olarak fark olmasa da hem Mallampati skoru hem de zor entübasyon skorları iskeletsel Sınıf 2 gruplarında daha yüksekti. Sonuç: Cerrah, uzamış ameliyat süresinin komplikasyon riskini artırabileceğinin farkında olurken, anestezi uzmanı ise Sınıf 2 iskeletsel deformiteye bağlı entübasyon zorluklarının farkında olmalıdır.
Anahtar Kelimeler: Ortognatik cerrahi; komplikasyon; genel anestezi; Mallampati skoru; Cormack Lehane skoru
Amaç: Ortognatik cerrahi ile dentofasiyal deformitelerin rekonstrüksiyonu ağız diş ve çene cerrahisi bölümünde en sık uygulanan işlemlerden birisidir. Genel anestezi ve ameliyat süresinin uzamasına bağlı olarak çeşitli komplikasyonlar ortaya çıkabilir. Bu çalışmanın amacı, iskeletsel deformitenin tipi ve ortognatik cerrahi tipinin anesteziye bağlı komplikasyonlara etkisini araştırmaktır. Genel anestezi altında ortognatik cerrahi uygulanan 202 hasta retrospektif olarak değerlendirilmiştir. Gereç ve Yöntemler: Yüz on dört hasta çalışmaya dâhil edildi. Hastalar cerrahi operasyonlarına göre tek çene (n=41) ve çift çene (n=73) cerrahi olarak 2 gruba ayrıldı. Doksan yedi hastada iskeletsel Sınıf 3 deformite ve 17 hastada Sınıf 2 deformite vardı. İntraoperatif cerrahi komplikasyon insidansı, cerrahinin süresi, entübasyon zorluğu, kan transfüzyonu, postoperatif yoğun bakım ihtiyacı ve/veya ek ilaç kullanımı analiz edildi. Anesteziye bağlı komplikasyonlar, gruplar arasında istatistiksel olarak karşılaştırıldı. Bulgular: Cerrahiye bağlı en yaygın komplikasyon 'bad' split olarak belirtilmiştir. Yaygın kan kaybı veya akciğer ödemi gibi hayatı tehdit eden komplikasyonların insidansı, iskeletsel Sınıf 2 hastalarda ve çift çene cerrahisi grubunda biraz daha yüksekti. Gruplar arasında istatistiksel olarak fark olmasa da hem Mallampati skoru hem de zor entübasyon skorları iskeletsel Sınıf 2 gruplarında daha yüksekti. Sonuç: Cerrah, uzamış ameliyat süresinin komplikasyon riskini artırabileceğinin farkında olurken, anestezi uzmanı ise Sınıf 2 iskeletsel deformiteye bağlı entübasyon zorluklarının farkında olmalıdır.
Anahtar Kelimeler: Ortognatik cerrahi; komplikasyon; genel anestezi; Mallampati skoru; Cormack Lehane skoru
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