Preoperative laboratory assessment of hemostasis for orthognathic surgery

Prevalence of systemic conditions in an orthognathic surgery population: A 20-year single-center study

OBJECTIVE

To describe the prevalence and characteristics of patients with systemic conditions in an orthognathic surgery population.

STUDY DESIGN

A retrospective review was conducted of 1653 patients undergoing orthognathic surgery between 2001 and 2020. Patients were grouped per category of systemic condition and relevant information was retrieved from medical records. Clinical and perioperative characteristics were compared between patients with and without systemic conditions using χ² tests and 95% confidence intervals. Age was compared using a cumulative logit model.

RESULTS

The proportion of patients with systemic conditions undergoing orthognathic surgery was 16% (272 of 1653 patients). Patients with systemic conditions were on average 6 years older than patients without systemic conditions (P < .001). Significant differences in age compared to healthy patients were found for endocrinological (12 years; 95% confidence interval [CI], 8-16 years), gastrointestinal (10 years; 95% CI, 3-18 years), pneumological (5 years; 95% CI, 2-13 years), and cardiovascular disorders (17 years; 95% CI, 12-21 years).

CONCLUSION

Nearly 1 out of 6 patients undergoing orthognathic surgery has a systemic condition. Knowledge of the prevalence and characteristics of these patients creates awareness among surgeons and a foundation for future studies on perioperative management.

Orthognathic surgery in a patient with hemophilia A: report of a case

Hemophilia A (factor VIII deficiency) is a bleeding disorder that is inherited in a recessive fashion and is caused by a mutation on the X chromosome. Management of bleeding disorders during orthognathic surgery cases has only been reported 2 other times in the oral and maxillofacial surgery literature. This report describes a patient with a factor VIII deficiency who underwent bilateral sagittal split osteotomies, a genial advancement, and extraction of teeth and the management of this patient from a hematologic standpoint.