What are the Effects of Internal Fixation on Trigeminal Neurosensory Function and the Temporomandibular Joints Following Intraoral Vertical Ramus Osteotomy?

Autor:	Lin SI; Assistant Professor, Department of Oral and Maxillofacial Surgery, Vanderbilt University Medical Center, Nashville, TN., McKenna SJ; Professor and Chair, Department of Oral and Maxillofacial Surgery, Vanderbilt University Medical Center, Nashville, TN. Electronic address: samuel.mckenna@vumc.org.
Jazyk:	angličtina
Zdroj:	Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons [J Oral Maxillofac Surg] 2023 Jun; Vol. 81 (6), pp. 708-715. Date of Electronic Publication: 2023 Mar 08.
DOI:	10.1016/j.joms.2023.02.019
Abstrakt:	Purpose: Intraoral vertical ramus osteotomy (IVRO) has, traditionally, been accomplished without internal fixation, necessitating a period of maxillomandibular fixation (MMF). With advances in instrumentation, internal fixation of IVRO is feasible, obviating the need for MMF. The purpose is to investigate the effects of transoral internal fixation on the prevalence of third division trigeminal nerve (CNV3) injury, temporomandibular joint (TMJ) arthralgia, and surgical site bleeding following IVRO. Materials and Methods: A retrospective study was conducted on patients who underwent IVRO at Vanderbilt University Medical Center between January 2017 and December 2020. The primary predictor variable was fixation status-internal fixation versus MMF. The primary outcome variable was postoperative CNV3 neurosensory disturbance. The secondary outcome variables were TMJ arthralgia and surgical site bleeding. Statistical analysis included Fisher's exact test and McNemar's Chi-squared test. Results: Seventy two subjects (59 IVROs without internal fixation and 65 IVROs with internal fixation) were studied. The frequency of CNV3 neurosensory deficit was 0% in the IVRO without internal fixation group and 3.1% in the IVRO with internal fixation group (P = .49). Within group analysis showed a decreased frequency of postoperative TMJ arthralgia compared to preoperative records in both groups (IVRO without internal fixation group, P = .04 and IVRO with internal fixation group, P = .004). The frequency of active surgical site bleeding controlled with local measures was 1.7% in the IVRO without internal fixation group and 3.1% in the IVRO with internal fixation group (P = 1). Conclusion: Internal fixation of IVRO is associated with low incidence of neurosensory deficit, TMJ arthralgia, and active surgical site bleeding. (Copyright © 2023 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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