Risk factors for postoperative facial swelling at 1 week after bimaxillary orthognathic surgery in Class III patients

Mari Shibata; Namiaki Takahara; Toma Kaneko; Meiko Oki; Yoshiyuki Sasaki; Nobuyoshi Tomomatsu; Yasuhiro Kurasawa; Koichi Nakakuki; Tetsuya Yoda

doi:10.1016/j.jormas.2023.101516

Risk factors for postoperative facial swelling at 1 week after bimaxillary orthognathic surgery in Class III patients

J Stomatol Oral Maxillofac Surg. 2023 Oct;124(5):101516. doi: 10.1016/j.jormas.2023.101516. Epub 2023 May 25.

Authors

Mari Shibata¹, Namiaki Takahara², Toma Kaneko³, Meiko Oki⁴, Yoshiyuki Sasaki¹, Nobuyoshi Tomomatsu¹, Yasuhiro Kurasawa¹, Koichi Nakakuki⁵, Tetsuya Yoda¹

Affiliations

¹ Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan.
² Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan. Electronic address: kounosur@tmd.ac.jp.
³ Center for Advanced Dental Clinical Education of Dental Hospital, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan.
⁴ Department of Basic Oral Health Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan.
⁵ Department of Acute Critical Care and Disaster Medicine, Graduate School for Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan.

PMID: 37236352
DOI: 10.1016/j.jormas.2023.101516

Abstract

Objective: To quantify facial swelling at 1 week after Le Fort I osteotomy and bilateral sagittal splitting ramus osteotomy in Class III patients and to identify factors contributing to the swelling based on clinical, morphologic, and surgical variables.

Study design: Data from 63 patients were examined in this single-center, retrospective study. Facial swelling was quantitatively measured by superimposing computed tomography data taken in the supine position at 1 week and 1 year postoperatively and extracting the area of maximum intersurface distance. Age, sex, body mass index, thickness of subcutaneous tissue, and of masseter muscle, maxillary length (A-VRP), mandibular length (B-VRP), and posterior maxillary height (U6-HRP), surgical movement (ΔA-VRP, ΔB-VRP, ΔU6-HRP), drainage method, and usage of facial bandages were examined. Multiple regression analysis was performed using the above factors.

Results: The median swelling at 1 week postoperatively was 8.35 IQR (5.99-11.47) mm. Multiple regression analysis revealed three factors that were significantly associated with facial swelling: Use of postoperative facial bandages (P=0.03), masseter muscle thickness (P=0.03), and ΔB-VRP (P=0.04).

Conclusion: Absence of a facial bandage, thin masseter muscle, and large horizontal mandibular movement are risk factors for facial swelling at 1 week postoperatively.

MeSH terms

Angioedema*
Face / surgery
Humans
Orthognathic Surgery*
Retrospective Studies
Risk Factors