Major Complications and Associated Risk Factors for Osseous Genioplasty with Bimaxillary Orthognathic Surgery: An American College of Surgeons-National Surgical Quality Improvement Program Analysis

Current Trends in Orthognathic Surgery

Orthognathic surgery has evolved significantly over the past century. Osteotomies of the midface and mandible are contemporaneously used to perform independent or coordinated movements to address functional and aesthetic problems. Specific advances in the past twenty years include increasing fidelity with computer-assisted planning, the use of patient-specific fixation, expanding indications for management of upper airway obstruction, and shifts in orthodontic-surgical paradigms. This review article serves to highlight the contemporary practice of orthognathic surgery.

Complications and Associated Risk Factors for Bimaxillary Osteotomies: A 15-Year Single-center Retrospective Study

AIM

The aim of this study was to retrospectively investigate the risk factors and their association on bimaxillary osteotomies to be able to improve patient selection and bimaxillary osteotomy planning.

MATERIAL AND METHODS

Patients treated with a bimaxillary osteotomy were included in the study. The complications were collected retrospectively from the patient data records. The effects of certain predictor variables on complication rates were also studied.

RESULTS

Sixty-one patients (48.0%) suffered from peri- or postoperative complications, or both. Twenty-five various perioperative complications were reported on 25 patients (19.6%) and 63 postoperative complications on 46 patients (36.2%). Ten patients (7.8%) suffered from both perioperative and postoperative complications. The effect of various predictor variables (sex, age, general health, type of malocclusion, surgery planning, use of bone grafts, and type of maxillary or mandibular movement) on complications was investigated, but we could not find any single factor to affect significantly on complication rate.

CONCLUSION

Both perioperative and postoperative complications are common in bimaxillary surgery, which must be noted in patient preoperative information. However, life-threatening complications are rare. Patient profile, bone grafting, type of osteosynthesis, or segmentation of the maxilla do not seem to affect the complication risk.