Young-Kyun Kim1, Su-Gwan Kim, Jong-Hwa Kim. 1. Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University, Bundang Hospital, Seongnam, Republic of Korea.
Abstract
PURPOSE: The purpose of this study was to evaluate the natural recovery of neurologic injury after orthognathic surgery based on subjective neurologic evaluation. PATIENTS AND METHODS: From December 2007 through June 2008, 47 patients (26 male, 21 female) from Seoul National University Bundang Hospital who had been treated with orthognathic surgery were identified. Subjective neurologic evaluation was performed 1 month, 3 months, and 6 months after surgery. Orthognathic surgery included bilateral sagittal split osteotomy (BSSO), BSSO plus genioplasty, BSSO plus Le Fort I, and BSSO plus Le Fort I plus genioplasty. RESULTS: Sensory changes occurred at the chin (55.7%) and lip (27.3%). Most patients reported an altered sensation when these body parts were touched. Visual analog scale (VAS) pain scores were 1.63 ± 1.89 (1 month postoperatively), 0.92 ± 1.34 (3 months postoperatively), and 0.95 ± 1.60 (6 months postoperatively); these values were not significantly different. VAS scores for altered sensation were 5.40 ± 2.83 (1 month postoperatively), 4.00 ± 2.35 (3 months postoperatively), and 3.36 ± 2.89 (6 months postoperatively). These differences were significant. For each surgery, the VAS of paresthesia decreased as time elapsed. The VAS of the altered sensation differed significantly after 1 month, 3 months, and 6 months whether or not genioplasty was performed. CONCLUSIONS: The results indicated that the altered sensation that may develop after orthognathic surgery is an unavoidable complication. Nevertheless, with time, the condition may resolve spontaneously. In patients who underwent simultaneous genioplasty, the incidence of altered sensation was high but was not significantly associated with the age of the patient or the performance of simultaneous maxillary surgery.
PURPOSE: The purpose of this study was to evaluate the natural recovery of neurologic injury after orthognathic surgery based on subjective neurologic evaluation. PATIENTS AND METHODS: From December 2007 through June 2008, 47 patients (26 male, 21 female) from Seoul National University Bundang Hospital who had been treated with orthognathic surgery were identified. Subjective neurologic evaluation was performed 1 month, 3 months, and 6 months after surgery. Orthognathic surgery included bilateral sagittal split osteotomy (BSSO), BSSO plus genioplasty, BSSO plus Le Fort I, and BSSO plus Le Fort I plus genioplasty. RESULTS: Sensory changes occurred at the chin (55.7%) and lip (27.3%). Most patients reported an altered sensation when these body parts were touched. Visual analog scale (VAS) pain scores were 1.63 ± 1.89 (1 month postoperatively), 0.92 ± 1.34 (3 months postoperatively), and 0.95 ± 1.60 (6 months postoperatively); these values were not significantly different. VAS scores for altered sensation were 5.40 ± 2.83 (1 month postoperatively), 4.00 ± 2.35 (3 months postoperatively), and 3.36 ± 2.89 (6 months postoperatively). These differences were significant. For each surgery, the VAS of paresthesia decreased as time elapsed. The VAS of the altered sensation differed significantly after 1 month, 3 months, and 6 months whether or not genioplasty was performed. CONCLUSIONS: The results indicated that the altered sensation that may develop after orthognathic surgery is an unavoidable complication. Nevertheless, with time, the condition may resolve spontaneously. In patients who underwent simultaneous genioplasty, the incidence of altered sensation was high but was not significantly associated with the age of the patient or the performance of simultaneous maxillary surgery.