Perioperative complications in corrective facial orthopedic surgery: A 5-year retrospective study

Purpose: Frequency and severity of complications have a profound impact on referral patterns fur facial orthopedic surgery. Therefore, a retrospective study was undertaken to determine the incidence of such problems in a larg e series of patients, with the intent to use these data to make possible ch anges in the perioperative protocol used in our clinic. Patients and Methods: The files of all patients operated on between 1992 an d 1996 were studied. These comprised 1,108 patients with 1,872 osteotomy pr ocedures. The following parameters were descriptively analyzed: airway obst ruction, hemorrhage, hematoma, infection, neurosensory disturbances, unfavo rable fractures, malposition of condyles and nasal septum, and vascularizat ion problems. Results: The most frequent complication was impairment of trigeminal nerve function. In 31.5% of the mandibular base osteotomies, 43.6% of the combine d mandibular base and chin osteotomies, and 13% of the chin osteotomies, li p sensibility was decreased immediately postoperatively. After 1 year, this number was reduced to approximately 5%. The function of 17 lingual nerves and 45 infraorbital nerves was temporarily impaired. A wound infection was next in frequency. Fifty-three infections (mandible-to-maxilla ratio, 2.5:1 ) were treated with drainage under local anesthesia and antibiotic therapy. Loss of part or all of an osteotomized segment did not occur. Other compli cations were rare and/or temporary. Conclusions: The most frequent complication was impairment of inferior alve olar nerve function. Life-threatening complications were not encountered. T he frequency of infections (<5%) requires further consideration regarding w ays to reduce the incidence. (C) 2000 American Association of Oral and Maxi llofacial Surgeons.