Complications of orthognathic surgery: Hospital de San José de Bogotá 2004-2007

Complicaciones de la cirugía ortognática: Hospital de San José de Bogotá 2004-2007

We present the complications of orthognathic surgery that occurred in patients operated at the Hospital of San José de Bogotá, from January 1, 2004 to May 31, 2007. As there was no statistical evaluation that gave a real vision of the situation of these patients in the hospital, a review of the databases of each service and of the clinical histories was carried out in order to describe the most frequent complications and their outcome. It was found that in this period 31 patients were operated on, of which 10 (32%) presented some complication. The most frequent was haemorrhage (13%), which in most cases manifested as epistaxis, followed in frequency by neurological deficit and anatomical alterations (6.5% each). There was only need to reoperate a patient (3.2%). The surgery that presented the greatest number of complications was bimaxillary. It is concluded that during the study period orthognathic surgery performed at the Hospital of San José de Bogotá presented a high percentage of complications (32%) compared to what is reported in the literature that is 6.4%, which can be explained by the low number of cases. None of the complications was serious.

1. Ayoub AF, Lalani Z, Moos KF, Wood GA. Complications following orthognathic surgery that required early surgical intervention: fifteen years' experience. Int J Adult Orthodon Orthognath Surg. 2001 ;16(2): 138-44.

2. Kramer FJ, Baethge C, Swennen G, Teltzrow T, Schulze A, Berten J, Brachvogel P. Intra- and perioperative complications of the LeFort I osteotomy: a prospective evaluation of 1000 patients. J Craniofac Surg. 2004 Nov;15(6):971-7.

3. Rosen HM. Aesthetic orthognatic surgery. En: Mathes S, Hentz VR. editors. Plastic Surgery. The head and neck. Philadelphia: Saunders; 2006. p.649-86.

4. Busby BR, Bailey LJ, Proffit WR, Phillips C, White RP Jr. Long-term stability of surgical class III treatment: a study of 5-year postsurgical results. Int J Adult Orthodon Orthognath Surg. 2002 Fall;17(3):159-70.

5. Becelli R, Fini G, Renzi G, Giovannetti F, Roefaro E. Complications of bicortical screw fixation observed in 482 mandibular sagittal osteotomies. J Craniofac Surg. 2004 Jan;15(1): 64-8.

6. Panula K, Finne K, Oikarinen K. Incidence of complications and problems related to orthognathic surgery: a review of 655 patients. J Oral Maxillofac Surg. 2001 Oct;59(10):1128-36.

7. Stewart A, Newman L, Sneddon K, Harris M. Aprotinin reduces blood loss and the need for transfusion in orthognathic surgery. Br J Oral Maxillofac Surg. 2001 Oct;39(5):365-70.

8. Spaey YJ, Bettens RM, Mommaerts MY, Adriaens J, Van Landuyt HW, Abeloos JV, De Clercq CA, Lamoral PR, Neyt LF. A prospective study on infectious complications in orthognathic surgery. J Craniomaxillofac Surg. 2005 Feb;33(1):24-9.

9. Gong SG, Krishnan V, Waack D. Blood transfusions in bimaxillary orthognathic surgery: are they necessary? Int J Adult Orthodon Orthognath Surg. 2002;17(4):314-7.

10. Westermark A, Shayeghi F, Thor A. Temporomandibular dysfunction in 1,516 patients before and after orthognathic surgery. Int J Adult Orthodon Orthognath Surg. 2001;16(2):145-51.

11. Baker SB, Weinzweig J, Bartlett SP, Whitaker LA. Brain abscess as a complication of orthognathic surgery: diagnosis, management, and pathophysiology. Plast Reconstr Surg. 1999 Aug;104(2):480-2.

12. Goldwin RM, Cohen N. Orthognathic surgery. En: Goldwyn RM, Cohen MN. The unfavorable result in plastic surgery: avoidance and treatment. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2001. p. 404-17.