Perioperative complications following sagittal split osteotomy of the mandible.
BACKGROUND
The aim of this study was to review complications in a series of 1264 consecutive patients who were operated in a single centre during a 20-year-period.


METHODS
Complications were documented, their incidences calculated and compared with data from the literature.


RESULTS
In 35 patients (2.8%) infection developed requiring extraoral incision and drainage; in 27 patients (2.1%) the inferior alveolar nerve was inadvertently cut; 18 patients (1.4%) had to undergo re-operation due to bending or fracture of osteosynthesis material; 15 patients (1.2%) suffered from bleeding complications; in 12 patients (0.9%) an unfavourable split occurred. In 8 patients (0.6%) foreign bodies were left in situ; in 7 patients a partial weakness of the facial nerve occurred, which was permanent in 1 patient. Six patients (0.5%) with a significantly higher age than average (mean: 33.6 years in comparison with 23.1 years) developed non-union at the site of osteotomy, and the mandible had to be bone grafted. Two patients (0.2%) developed osteomyelitis, and in one patient airway problems led to a need for tracheostomy (0.1%).


CONCLUSIONS
Although some of these complications of bilateral sagittal split with osteotomy carry severe limitations in health related quality of life, it remains an overall safe procedure, demanding, however, comprehensive informed consent. Good knowledge of technical reasons for these complications should help to reduce their incidence.
Teltzrow
Thomas
T
Department of Oral and Maxillofacial Surgery, Medical University of Hannover, Germany. teltzrow-hannover@t-online.de
Kramer
Franz-Josef
FJ
Schulze
Andrea
A
Baethge
Carola
C
Brachvogel
Peter
P
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000402:Airway Obstruction / Q000209:etiology; D016063:Blood Loss, Surgical; D001860:Bone Plates / Q000009:adverse effects; D004868:Equipment Failure; D005155:Facial Nerve Diseases / Q000209:etiology; D005260:Female; D005547:Foreign Bodies / Q000209:etiology; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008334:Mandible / Q000601:surgery*; D008875:Middle Aged; D010019:Osteomyelitis / Q000209:etiology; D010027:Osteotomy / Q000009:adverse effects*; D011183:Postoperative Complications; D019106:Postoperative Hemorrhage / Q000209:etiology; D012086:Reoperation; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000209:etiology; D061221:Trigeminal Nerve Injuries; D014945:Wound Healing