Is injury to the inferior alveolar nerve still common during orthognathic surgery? Manual twist technique for sagittal split ramus osteotomy

2018 ◽  
Vol 56 (10) ◽  
pp. 946-951 ◽  
Author(s):  
Bong-Kyoon Choi ◽  
Won Lee ◽  
Lun-Jou Lo ◽  
Eun-Jung Yang
Keyword(s):  
Orthognathic Surgery ◽  
Inferior Alveolar Nerve ◽  
Sagittal Split Ramus Osteotomy

scholarly journals Osteossíntese no Tratamento Cirúrgico dos Prognatismos: Estado da Arte

2017 ◽  
Vol 30 (3) ◽  
pp. 224
Author(s):  
Nuno Durão ◽  
José Amarante
Keyword(s):  
Relevant Literature ◽  
Inferior Alveolar Nerve ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Sagittal Split Ramus Osteotomy ◽  
Acceptable Alternative ◽  
Mandibular Setback ◽  
Common Technique ◽  
The Stability

Introduction: Prognathism is a common skeletal facial abnormality, associated with class III malocclusion, often with repercussions in quality of life. In addition to orthodontic treatment, sagittal split ramus osteotomy is the most common technique for its correction, and segment osteosynthesis is an important element of the post-surgical outcome.Materials and Methods: A search for relevant literature was conducted in the PubMed/MEDLINE database and in other relevant sources.Results: The stability of different fixation methods, their repercussions on inferior alveolar nerve lesions, and the type of material are among the most researched subjects.Discussion: Recent research about the type of osteosynthesis applied in the sagittal split ramus osteotomy for mandibular setback is discussed.Conclusion: Miniplates appear to be the better option for fixation of sagittal split osteotomy for mandibular setback. Bioabsorbable osteosynthesis may be an acceptable alternative to titanium.

scholarly journals Sudden arrhythmia followed by bradycardia during sagittal split ramus osteotomy: trigeminocardiac reflex

2019 ◽  
Vol 12 (12) ◽  
pp. e232784 ◽  
Author(s):  
Hyunjee Kim
Keyword(s):  
Orthognathic Surgery ◽  
Heart Rhythm ◽  
Anticholinergic Agent ◽  
Anticholinergic Agents ◽  
Intravenous Lidocaine ◽  
Sagittal Split Ramus Osteotomy ◽  
Trigeminocardiac Reflex ◽  
Brainstem Reflex ◽  
Surgical Manipulation ◽  
Stimulation Of

Trigeminocardiac reflex (TCR) is a brainstem reflex triggered by the stimulation of any branch of the fifth cranial nerve along its course, presenting as a reduction in heart rate and blood pressure. Oculocardiac reflex is a well-known subtype of TCR. In the case reported here, remarkable arrhythmia followed by bradycardia occurred suddenly in a healthy patient undergoing orthognathic surgery. The heart rhythm recovered when the surgical manipulation ceased, but bradycardia was reproduced when the surgery resumed. This case of TCR is unique in that remarkable arrhythmia first appeared and led to bradycardia; accordingly, intravenous lidocaine and an anticholinergic agent were administered simultaneously instead of anticholinergic agents alone, and were protective. Although TCR rarely occurs during orthognathic surgery, clinicians should be aware of its possibility and able to judge and manage it promptly.

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