Maxillofacial Plastic and Reconstructive Surgery

Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
권호 표지

Facial Nerve Palsy after Bilateral Sagittal Split Ramus Osteotomy: Case Report

양측 하악지 시상골 절단술 후 발생한 안면 신경 마비의 증례

  • Jin, Soo-Young (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University) ;
  • Kim, Su-Gwan (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University) ;
  • Kim, Hak-Kyun (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University) ;
  • Moon, Seong-Yong (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University) ;
  • Oh, Ji-Su (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University) ;
  • Jeong, Kyung-In (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University) ;
  • Jeon, Woo-Jin (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University) ;
  • Yun, Dae-Woong (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University) ;
  • Yang, Seok-Jin (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University)
  • 진수영 (조선대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 김수관 (조선대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 김학균 (조선대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 문성용 (조선대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 오지수 (조선대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 정경인 (조선대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 전우진 (조선대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 윤대웅 (조선대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 양석진 (조선대학교 치의학전문대학원 구강악안면외과학교실)
  • Received : 2011.02.16
  • Accepted : 2011.05.02
  • Published : 2011.05.31
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Abstract

BSSRO (bilateral sagittal split ramus osteotomy) is an effective surgical method for maxillofacial deformities. Rigid fixation using a plate and screws can stabilize bony segments and induce early mouth opening. Though this procedure has a low complication rate, normal function and esthetic recovery is achieved through proper and early management of the complications. Complications consisting of temporomandibular disorders, sensory disturbances due to inferior alveolar nerve damage, open bite, malunion or nonunion, and facial nerve palsy occur, but these rarely develop. Facial nerve palsy causes the muscles involved in facial expression to depress, which results in ocular dryness or retinal damage. When facial nerve palsy develops, early management involving steroid medication and physical therapy is effective. In the case of severe damage, surgical intervention should be considered. A 20-year-male patient came to the oral and maxillofacial surgery department for orthognathic surgery. The mandible was set back by BSSRO under general anesthesia. Facial nerve palsy was observed on the left side of the face: steroid and vitamins were administered early and physical therapy was performed daily. These forms of management can aid in function and allow for gradual esthetic recovery. Presumed causes were excessive soft tissue retraction or soft tissue injury by the osteotome at the horizontal osteotomy of the ramus. Careful dissection, retraction and a precise osteotomy are needed for protection of the facial nerve. If nerve damage is observed, early management can help in the recovery of facial nerve function and esthetics.

Keywords

References

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