Maxillary sinus haziness and facial swelling following suction drainage in the maxilla after orthognathic surgery

Abstract

Background We investigated the efficacy of a maxillary Jackson-Pratt (J-P) suction drain for preventing maxillary sinus hematoma and facial swelling after maxillary Le Fort I osteotomy (LF1). Methods We retrospectively evaluated 66 patients who underwent LF1 at a single institution. Of these, 41 had a J-P suction tube inserted in the mandible and maxilla (maxillary insertion), and 25 had a J-P drain inserted in the mandible only (no maxillary insertion). Facial CT was obtained before and 4 days after surgery. We compared mean midfacial swelling and maxillary sinus haziness by t test and examined correlations between bleeding amount and body mass index (BMI). Results For the maxillary-insertion group, the ratio of total maxillary sinus volume to haziness (57.5 ± 24.2%) was significantly lower than in the group without maxillary drain insertion (65.5% ± 20.3; P = .043). This latter group, however, did not have a significantly greater midfacial soft tissue volume (7575 mm3) than the maxillary-insertion group (7250 mm3; P = .728). BMI did not correlate significantly with bleeding amount or facial swelling. Conclusions Suction drainage in the maxilla reduced maxillary sinus haziness after orthognathic surgery but did not significantly reduce midfacial swelling.

Evaluation of Related Factors of Maxillary Sinusitis After Le Fort I Osteotomy Based on Computed Tomography: A Retrospective Case-Control Study

“…Timely drainage of maxillary sinus fluid is beneficial to reduce the risk of maxillary sinus infection and inflammation. 9 If the longtime obstruction of MSO or the tendency of maxillary sinusitis is found, the timely opening and enlarging of the MSO by specialized drugs or endoscopic surgery, and drainage intervention with some measures should be conducted to avoid the spread of inflammation that can affect the stomatal complex and other paranasal sinuses. 11 On the other hand, considering that the drainage of MSO at T1 and T2 both affect T3, the preoperative and immediately postoperative patency of MSO should be noted.…”

“…At the same time, we quantified the volume of the mucosal thickening of the maxillary sinus cavity by CT at T3 to evaluate the severity of inflammation. 7,9 For volume analysis, the data were analyzed by using the SimPlant Pro 11.04 (Materialise, Leuven, Belgium) software program. The CT data in DICOM format was imported to SimPlant Pro 11.04; "Segment," "Segmentation wizard," and "Define anatomic type" were chosen; and we selected the pixels regarded as the maxillary sinus on all coronal and axial images, measured the air cavity itself and the complete sinus cavity of the maxillary sinus.…”

“…8 After surgery, blood and other liquids accumulate in the sinus, which results in the thickening of sinus mucosa and even the maxillary sinusitis in severe cases. 9,10 Postoperative maxillary sinusitis not only causes symptoms such as nasal congestion and runny nose but also result in slow persistent facial swelling and regression, which can seriously affect the patients’ quality of life. 8 Also, some of these symptoms do not improve until the patients undergo secondary surgical treatment.…”

Index of Body Inflammation for Maxillofacial Surgery Purpose-to Make the Soluble Urokinase-Type Plasminogen Activator Receptor Serum Level Independent on Patient Age

“…Inflammatory postoperative direct complications after maxillofacial surgery have been already known [5,24]. It could be related to other indirect complications, such as rhinitis and empyema [2,25,26].…”

“…When midface is operated on, the maxillary sinuses are filled with blood, which may be infected [4]. Postoperative swelling also needs to be considered after orthognathic surgery, as the result of the onset of an infection or a harmless postoperative reaction [5]. The only dangerous condition of mentioned series is a developing infection.…”