양측 하악지 시상 골절단술은 악안면 기형 및 부정교합을 치료하기 위해 흔히 사용되는 필수불가결한 술식이라고 할 수 있다. 하악지 시상 골절단술 후 발생할 수 있는 합병증으로는 하치조 신경 손상, 출혈, 측두하악장애, 부적절한 골면의 유합 및 골절, 재발 등이 있다. 악교정 수술 후 안면신경 마비의 발생 유병율은 최근 0.1 퍼센트로 보고되고 있다. 증상 발생의 원인으로는 안면신경의 압박, 신경의 불완전 또는 완전 손상, 신경의 견인, 마취제에 의한 신경의 허혈 등이 있다. 술 후 발생된 안면 신경의 마비는 환자의 삶의 질을 저해하고 사회활동을 기피하게 함으로써 가장 심각한 합병증 중 하나라고 볼 수 있다. 본 증례에서는 양측 하악지 시상 골전달술을 시행 후 발생한 안면신경 마비에 대하여 보고하고 있다.
양측 하악지 시상 골절단술은 악안면 기형 및 부정교합을 치료하기 위해 흔히 사용되는 필수불가결한 술식이라고 할 수 있다. 하악지 시상 골절단술 후 발생할 수 있는 합병증으로는 하치조 신경 손상, 출혈, 측두하악장애, 부적절한 골면의 유합 및 골절, 재발 등이 있다. 악교정 수술 후 안면신경 마비의 발생 유병율은 최근 0.1 퍼센트로 보고되고 있다. 증상 발생의 원인으로는 안면신경의 압박, 신경의 불완전 또는 완전 손상, 신경의 견인, 마취제에 의한 신경의 허혈 등이 있다. 술 후 발생된 안면 신경의 마비는 환자의 삶의 질을 저해하고 사회활동을 기피하게 함으로써 가장 심각한 합병증 중 하나라고 볼 수 있다. 본 증례에서는 양측 하악지 시상 골전달술을 시행 후 발생한 안면신경 마비에 대하여 보고하고 있다.
Bilateral sagittal split ramus osteotomy(BSSRO) of the mandible is an essential and commonly used procedure to correct dentofacial deformities and malocclusion. The possible complications associated with BSSRO include inferior alveolar nerve injury, bleeding, temporomandibular disorder, unfavorable ...
Bilateral sagittal split ramus osteotomy(BSSRO) of the mandible is an essential and commonly used procedure to correct dentofacial deformities and malocclusion. The possible complications associated with BSSRO include inferior alveolar nerve injury, bleeding, temporomandibular disorder, unfavorable fractures, and clinical relapse. The incidence of facial nerve palsy after orthognathic surgery recently reported is 0.1%. The probable etiologies have included facial nerve compression, complete or incomplete nerve transection, nerve traction, and nerve ischemia from anesthetic injection. Postoperative facial palsy is one of the most serious complications because it reduces the quality of life and significantly reduces social interaction. The case of a 24-year-old patient who underwent bilateral sagittal split ramus osteotomy is described. The medical records and postoperative photographs were reviewed in detail to collect information on the clinical course, treatment, and outcomes.
Bilateral sagittal split ramus osteotomy(BSSRO) of the mandible is an essential and commonly used procedure to correct dentofacial deformities and malocclusion. The possible complications associated with BSSRO include inferior alveolar nerve injury, bleeding, temporomandibular disorder, unfavorable fractures, and clinical relapse. The incidence of facial nerve palsy after orthognathic surgery recently reported is 0.1%. The probable etiologies have included facial nerve compression, complete or incomplete nerve transection, nerve traction, and nerve ischemia from anesthetic injection. Postoperative facial palsy is one of the most serious complications because it reduces the quality of life and significantly reduces social interaction. The case of a 24-year-old patient who underwent bilateral sagittal split ramus osteotomy is described. The medical records and postoperative photographs were reviewed in detail to collect information on the clinical course, treatment, and outcomes.
* AI 자동 식별 결과로 적합하지 않은 문장이 있을 수 있으니, 이용에 유의하시기 바랍니다.
제안 방법
A healthy 24-year-old man with prognathism underwent a bilateral sagittal split ramus osteotomy(BSSRO). Orthodontic treatment had been given for 12 months, and orthognathic surger involved a BSSRO to set back the mandible 18mm, on both sides. The intraoperative course was uneventful and ice packs were applied during the first 24 hours postoperatively.
5) The case of a 24-year-old patient who underwent bilateral sagittal split ramus osteotomy is described. The medical records and postoperative photographs were reviewed in detail to collect information on the clinical course, treatment, and outcomes.
The patient was given steroid therapy(prednisone 10mg 3 times daily for 2 weeks and thereafter a tapering dose for 1 weeks) for 1 month and physical therapy with electrical stimulation(transcutaneous electrical nerve stimulator:TENS), and active exercise of the facial muscles. An eye patch, ointment for the left eye, and lubrication were prescribed by an opthalmologist.
성능/효과
The starting dosage was 600mg/day(200mg 3 times for 2 weeks) and thereafter increasing 900mg/day for 2 weeks. Two months follow-up visit, a complete recovery of all left-sided facial muscle movement was seen without residual asymmetry,(Fig. 3.) and there was no pain in the affected area, so the gabapentin prescription was stopped.
후속연구
Even though there has been no published data about promoting regeneration of facial nerve with gabapentin and this is a single patient case report, gabapentin might be helpful to improve facial nerve function. Further investigation should be taken to prove this hypothesis.
참고문헌 (19)
Kim SG, Park SS. Incidence of complications and problems related to orthognathic surgery. J Oral Maxillofac Surg 2007;65(12):2438-2444.
Ruiz LP, Lara JC. Facial nerve palsy following bilateral sagittal split ramus osteotomy for setback of the mandible. Int J Oral Maxillofac Surg 2011;40 (8):884-886.
Rai KK, Shivakumar HR, Sonar MD. Transient facial nerve palsy following bilateral sagittal split ramus osteotomy for setback of the mandible: a review of incidence and management. J Oral Maxillofac Surg 2008;66(2):373-378.
de Santana Santos T, Albuquerque KM, Santos ME, Laureano Filho JR. Survey on complications of orthognathic surgery among oral and maxillofacial surgeons. J Craniofac Surg 2012;23(5):e423-430.
de Vries K, Devriese PP, Hovinga J, van den Akker HP. Facial palsy after sagittal split osteotomies. A survey of 1747 sagittal split osteotomies. J Craniomaxillofac Surg 1993;21(2):50-53.
Lanigan DT, Hohn FI. Facial nerve injuries after sagittal split mandibular ramus osteotomies for advancement: a report of 2 cases and review of the literature. J Oral Maxillofac Surg 2004;62(4):503-507.
Al-Bishri A, Dahlin L, Sunzel B, Rosenquist J. Systemic betamethasone accelerates functional recovery after a crush injury to the rat sciatic nerve. J Oral Maxillofac Surg 2005;63(7):973-977.
Kusunose N, Koyanagi S, Hamamura K et al. Molecular basis for the dosing time-dependency of anti-allodynic effects of gabapentin in a mouse model of neuropathic pain. Mol Pain 2010;26;6:83.
Jaggi AS, Singh N. Role of different brain areas in peripheral nerve injury-induced neuropathic pain. Brain Res 2011;24;1381:187-201.
Davies A, Hendrich J, Van Minh AT, Wratten J, Douglas L, Dolphin AC. Functional biology of the alpha(2)delta subunits of voltage-gated calcium channels. Trends Pharmacol Sci 2007;28(5):220-228.
Scheller K, Scheller C. Nimodipine promotes regeneration of peripheral facial nerve function after traumatic injury following maxillofacial surgery: an off label pilot-study. J Craniomaxillofac Surg 2012;40(5):427-434.
Jain Y, Falcioni M, Agarwal M, Taibah A, Sanna M. Total facial paralysis after vestibular schwannoma surgery: probability of regaining normal function. Ann Otol Rhinol Laryngol 2004;113(9):706-710.
Jin SY, Kim SG, Kim HG et al. Facial nerve palsy after Bilateral Sagittal Split Ramus Osteotomy: Case report. J Korean Assoc Maxillofac Plast Reconstr Surg 2011;33(3):276-280.
※ AI-Helper는 부적절한 답변을 할 수 있습니다.