Main

Meisami T, Musa M et al. Oral Surg 2007; 103: 458–463

Airway obstruction following orthognathic surgery (OGS) is a rare, life-threatening complication about which little has been reported. In this study, the airways of 40 patients undergoing OGS were assessed pre-operatively and 24-48 hours subsequently (expected time of maximum oedema), using magnetic resonance imaging (MRI). Scans were examined in masked (blinded) conditions.

The OGS procedures, alone or in combination, were Le Fort I osteotomy (34 patients), bilateral sagittal split osteotomy (23) and genioplasty (25). In no case was airway oedema or compromise identified by MRI, despite clinically obvious oedema of lips, cheeks and upper necks. The authors comment that in the absence of other clinical signs, routine admission to intensive care and overnight intubation appear unnecessary, and that intermaxillary fixation is not needed where rigid fixation has been used.