http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
Clinical investigation of patients with jaw deformity with comorbidities
Kiyohiro Kasahara,Teruhide Hoshino,Kei Sugiura,Yuki Tanimoto,Masahide Koyachi,Masae Yamamoto,Keisuke Sugahara,Masayuki Takano,Akira Katakura 대한악안면성형재건외과학회 2022 Maxillofacial Plastic Reconstructive Surgery Vol.44 No.-
Background: With improvements in the safety and stability of surgeries, the number of orthognathic surgeries isincreasing. Most patients who undergo orthognathic surgeries are younger, and the number of orthognathic surgeriesfor patients with comorbidities is also increasing. We report a survey and clinical investigation of patients withcomorbidities who underwent orthognathic surgeries at our department to improve the safety of orthognathicsurgery. Results: The participants included 296 men and 712 women, with a mean age of 28 years (13?19 years, n=144;20?29 years, n=483; 30?39 years, n=236; 40?49 years, n=102; 50?59 years, n=39; ≥60 years, n=4). In total, 347patients underwent one-stage Le Fort type I osteotomy and sagittal split ramus osteotomy (SSRO), 243 underwentSSRO, 287 underwent plate removal, 126 underwent genioplasty and plate removal, and five underwent othersurgeries. In total, 529 patients had comorbidities (52%), including allergic diseases (n=220, 33%), respiratory diseases(n=107, 16%), neurologic and psychiatric diseases (n=69, 10%), gynecologic diseases (n=28, 4%), hematologicdiseases (n=27, 4%), cardiovascular diseases (n=24, 4%), digestive diseases (n=22, 3%), metabolic and endocrinediseases (n=18, 3%), spinal diseases (n=11, 2%), ophthalmologic diseases (n=11, 2%), renal and urological diseases(n=9, 1%), and other diseases (n=117, 18%). Among the patients with comorbidities, 11 with hemorrhagic diatheses(hemophilia and von Willebrand disease), arrhythmia (atrioventricular block), psychiatric disease (adjustment disorder),and metabolic disease (diabetes) required cautious perioperative management. The patient with hemophilia wasmanaged with regular low-dose recombinant factor VIII replacement therapy, and the patient with type I diabetesmellitus was administered continuous insulin infusion and sliding-scale insulin therapy; both patients had an uneventfulcourse. Conclusions: The study findings suggest that with the increase in orthognathic surgeries, oral and maxillofacialsurgeons should adequately manage cases requiring cautious perioperative control and highlight the importance ofpreoperative screening. Despite the well-established safety and postoperative stability of orthognathic surgeries, oralsurgeons should adopt appropriate additional preventive measures for patients with comorbidities.