Postoperative Complications in Genioplasty and Their Association with Age, Gender, and Type of Genioplasty

Objective. The objective of our study was to determine the incidence of postoperative complications associated with different kinds of genioplasties done with or without concomitant orthognathic surgeries. Materials and Methods. Patients in whom facial asymmetry was corrected by genioplasty with age ranging from 16 to 55 at the Department of Oral and Maxillofacial Surgery were included in the study. Patients with facial asymmetry due to congenital problems were excluded. Results. 59 patients were included, of which 38 were males and 21 were females with the age range of 16–55 (mean: 27.3729, Std. deviation: 4.70472). Advancement genioplasty was performed in 15.3%, reduction genioplasty was done in 16.9%, and advancement genioplasty with rotation was performed in 67.8% cases. In 28.8% cases, genioplasty was performed as an adjunct procedure with orthognathic surgery, and in 71.2% cases, genioplasty was performed alone. 3.4% patients developed infection, 8.5% had hematoma, and 6.8% had temporary numbness. Postoperative complications were seen more in men than in women. Correction of chin asymmetry by rotation/advancement showed the highest number of complications (84%). Conclusion. Temporary neurosensory disturbance of the inferior alveolar nerve is the most common complication that occurs after genioplasty. Patients shall be counselled preoperatively, and informed consent shall be obtained prior to surgery.

A Comprehensive Examination of Severely Ill ME/CFS Patients

One in four myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) patients are estimated to be severely affected by the disease, and these house-bound or bedbound patients are currently understudied. Here, we report a comprehensive examination of the symptoms and clinical laboratory tests of a cohort of severely ill patients and healthy controls. The greatly reduced quality of life of the patients was negatively correlated with clinical depression. The most troublesome symptoms included fatigue (85%), pain (65%), cognitive impairment (50%), orthostatic intolerance (45%), sleep disturbance (35%), post-exertional malaise (30%), and neurosensory disturbance (30%). Sleep profiles and cognitive tests revealed distinctive impairments. Lower morning cortisol level and alterations in its diurnal rhythm were observed in the patients, and antibody and antigen measurements showed no evidence for acute infections by common viral or bacterial pathogens. These results highlight the urgent need of developing molecular diagnostic tests for ME/CFS. In addition, there was a striking similarity in symptoms between long COVID and ME/CFS, suggesting that studies on the mechanism and treatment of ME/CFS may help prevent and treat long COVID and vice versa.

Effectiveness of low-level laser therapy on recovery from neurosensory disturbance after sagittal split ramus osteotomy: a systematic review and meta-analysis

Background Orthognathic surgery such as bilateral sagittal split ramus osteotomy (BSSRO) for the treatment of mandibular deformities is one of the most common procedures in maxillofacial operations that may lead to neurosensory disturbance. In this study, we aimed to evaluate the effectiveness of low-level laser therapy (LLLT) on augmenting recovery of neurosensory disturbance of inferior alveolar nerve (IAN) in patients who underwent BSSRO surgery. Methods A comprehensive literature search was conducted by two independent authors in PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, Embase, and Google Scholar electronic databases. Besides, a manual search of all textbooks and relevant articles were conducted. Searches took place in August 2020 and were limited to published and peer-reviewed articles from 2000 to 2020. All analysis was performed using the comprehensive meta-analysis (CMA) and the STATA MP (version:16) software. The weighted mean difference (WMD) using the inverse variance method and the standard mean difference (SMD) was considered for continuous variables. Results Seventy-four papers were retrieved after removing duplicate studies and finally, eight studies were assessed for qualitative synthesis and five for meta-analysis. Totally, 94 patients were included in the meta-analysis. Based on the meta-analysis, it was shown that LLLT was not effective in a short interval (0 to 48 h) after surgery, but in a period of more than 1 month after surgery, the positive results of treatment can be observed strikingly. Also, LLLT side/group showed no significant difference in some aspects of neurosensory recovery such as thermal sensation compared to the placebo side/group. Conclusions The meta-analysis of randomized controlled trials revealed that LLLT generally improves IAN sensory disturbance caused by BSSRO. Further high-quality clinical trials with longer follow-up periods and larger sample sizes are recommended.