Peripheral facial palsy after set-forward orthognathic surgery: A case report and review of literature

Mitate, Eiji; Toyoshima, Takeshi; Noguchi, T.; Kitahara, Tatsumi; Takahashi, Ichiro; Ikebe, Tetsuro; Nakamura, Seiji

doi:10.1016/j.ajoms.2017.11.002

Cited by 3 publications

(3 citation statements)

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“…44,45 Serologic tests are useful when coincidental viral infection is suspected; paired serum samples may help to determine herpes simplex and varicella zoster virus infection. 46 The degree of nerve injury has important implications in predicting the potential for functional recovery. According to the classification of nerve injury by Seddon, in cases of neurapraxia or axonotmesis, complete nerve regeneration is expected, but in neurotmesis cases, recovery occurs more slowly and is generally insufficient or poor without surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

“…44,45 Serologic tests are useful when coincidental viral infection is suspected; paired serum samples may help to determine herpes simplex and varicella zoster virus infection. 46…”

Section: Discussionmentioning

confidence: 99%

“…In cases where concomitant viral infection is suspected as a cause of facial palsy, it would be ideal to administer antiviral agents, in addition to early administration of steroids. 46,49 Other treatment modalities such as vitamin B may also be beneficial for facial nerve recovery. 50 Along with these active interventions, eye protective measures are necessary to prevent ophthalmic complications until enough nerve recovery is observed.…”

Section: Discussionmentioning

confidence: 99%

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Facial palsy after orthognathic surgery: Incidence, causative mechanism, management, and outcome

Hattori¹,

Huang²,

Chang³

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Background: Facial palsy after orthognathic surgery is an uncommon but serious complication causing dissatisfaction and affecting quality of life. The occurrence could be underreported. Surgeons need to recognize this issue regarding the incidence, causative mechanism, managements, and outcome. Methods: A retrospective review of orthognathic surgery records between January of 1981 and May of 2022 was conducted in the authors' craniofacial center. Patients who developed facial palsy after the surgery were identified, and demographics, surgical methods, radiologic images, and photographs were collected. Results: A total of 20,953 sagittal split ramus osteotomies (SSROs) were performed in 10,478 patients. Twenty-seven patients developed facial palsy, resulting in an incidence of 0.13% per SSRO. In a comparison of SSRO technique, the Obwegeser-Dal Pont technique using osteotome for splitting had higher risk of facial palsy than the Hunsuck technique using the manual twist splitting (P < 0.05). The severity of facial palsy was complete in 55.6% of patients and incomplete in 44.4%. All patients were treated conservatively, and 88.9% attained full recovery in a median duration of 3 months [interquartile range (IQR), 2.75 to 6 months] after surgery, whereas 11.1% attained partial recovery. Initial severity of facial palsy predicted the timing of recovery, with incomplete palsy patients having faster median recovery (3 months; IQR, 2 to 3 months) than the complete palsy patients (6 months; IQR, 4 to 6.25 months) (P = 0.02). Conclusions: The incidence of facial palsy after orthognathic surgery was 0.13%. Intraoperative nerve compression was the most likely causative mechanism. Conservative treatment is the mainstay of therapeutic strategy, and full functional recovery was anticipated.

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Section: Discussionmentioning

confidence: 99%

“…44,45 Serologic tests are useful when coincidental viral infection is suspected; paired serum samples may help to determine herpes simplex and varicella zoster virus infection. 46…”

Section: Discussionmentioning

confidence: 99%