This study discusses laryngospasm following orthognathic surgery and requiring emergency intubation, followed by systemic complications due to a hypoxic event. A 34-year-old male patient underwent orthognathic surgery due to facial asymmetry. When emerging from general anesthesia, blood pressure elevated suddenly, and severe agitation occurred. After extubation, desaturation occurred immediately, resulting in cyanosis and loss of consciousness. An emergency cricothyroidotomy was performed, and oral intubation was required to maintain the airway. The patient was sent to the intensive care unit on a ventilator. On postoperative day 2, the red blood cell count and hemoglobin level decreased significantly. Electrocardiogram showed abnormalities, although vital signs were stable and no bleeding was observed. Laryngospasm often occurs under general anesthesia, resulting in sustained closure of the vocal cords and obstruction of the airway. This condition can be life-threatening, and awareness of the various precipitating factors is important. Orthognathic surgery is a risk factor for laryngospasm because its surgical site affects the airway, and it involves discharge of blood via intraoral wounds. It is important to understand systemic changes occurring after a hypoxic event, and consultation with specialists from various departments should be actively pursued.
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http://dx.doi.org/10.5125/jkaoms.2024.50.5.297 | DOI Listing |
J Craniomaxillofac Surg
December 2024
Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa, Israel; Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; Department of Oral and Maxillofacial rehabilitation, Rambam Health Care Campus, Haifa, Israel.
As maxillofacial surgery becomes increasingly digitized and the transformative impact of pre-surgical scanning and computer simulation is recognized, this clinical paper presents an algorithm for the selection of interventions in severe congenital oligodontia with Angle class-III malocclusion (OCIII) utilizing such technologies. A complex, multifactorial condition with varying degrees of craniofacial involvement, OCIII is associated with edentulous facial appearance, mandibular prognathism and deep underbite, as well as malocclusion. Our methodology involves the integration of CBCT imaging, intra- and extra- oral scanning, and 3D planning with the assessment of bone volume, number of missing teeth, skeletal discrepancies, and patient compliance in the selection of suitable treatments.
View Article and Find Full Text PDFMalays J Pathol
December 2024
Universiti Malaya, Faculty of Dentistry, Department of Oral & Maxillofacial Clinical Sciences, 50603, Kuala Lumpur, Malaysia.
The surgical ciliated cyst is a newly added entity under the cysts of the jaws in the World Health Organization (WHO) Classification of Head and Neck Tumours (2022). It is preceded by a prior surgery to the jaw many years before its diagnosis. A 53-year-old Chinese female, who had undergone cleft lip and palate repair followed by orthognathic surgery before the age of 20, was referred for management of an incidentally found cyst in the left maxilla.
View Article and Find Full Text PDFJ Craniofac Surg
October 2024
Department of Maxillofacial Surgery, Hospital del Salvador, Santiago, Chile.
Condylar hyperplasia (CH) is a complex, usually unilateral pathology affecting the jaw, leading to facial asymmetry and malocclusion. Its etiology is unclear, with potential links to endocrine disorders, trauma, and genetic factors. Unilateral condylar hyperplasia (UCH) typically presents in young patients but can occur at any age.
View Article and Find Full Text PDFJ Craniofac Surg
October 2024
State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Center of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan.
Skeletal Class III malocclusion deformity is one of the most common maxillofacial malocclusions in East Asia and is either due to maxillary retrusion, mandibular protrusion, or both. It could cause functional and aesthetic problems. This deformity could be attributed to either hereditary or environmental factors or both.
View Article and Find Full Text PDFJ Craniofac Surg
October 2024
Department of Oral Maxillofacial Surgery, Walter Reed National Military Medical Center.
Congenital infiltrating lipomatosis of the face is a rare aggressive-benign disorder characterized by progressive hemifacial overgrowth and complex, often asymmetrical, facial differences. Recently linked with the PIK3CA-Related Overgrowth Spectrum, it arises from mosaic mutations in the PIK3CA gene. Treatment, largely supportive and tailored to individual clinical presentations, requires a multidisciplinary approach.
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