顎矯正手術が躊躇されたハイリスクの顎変形症患者に対する外科的矯正治療について

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  • Surgical Orthodontic Treatment for High-risk Patients with Jaw Deformities Whose Orthodontist Hesitated to Treat with Orthognathic Surgery

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<p>　　This study retrospectively evaluated the records of 5 high-risk patients with jaw deformities whose orthodontist hesitated to perform orthognathic surgery. Among these 5 patients, 2 were Jehovah’s Witnesses and thus refused blood transfusions, 2 were diagnosed with psychiatric disorders, and 1 reported a history of bisphosphonate administration. For the 2 patients who refused blood transfusions, the estimated blood loss was 65 and 70 ml during intraoral vertical ramus osteotomy and double-jaw surgery, respectively. No blood transfusions were performed for either patient. For the second patient, surgery was canceled once because consent for blood transfusion was not obtained. The patient with a history of bisphosphonate administration was treated using sagittal split ramus osteotomy and bone fusion was normal. Of the patients with psychiatric disorders, 1 patient with depression underwent double-jaw surgery without any postoperative complications. The other patient who was diagnosed with depression and schizophrenia also underwent double-jaw surgery. Postoperatively, few treatments were administered, and previous treatments were terminated. Overall, our experience with such patients suggested that close interdepartmental coordination was important for carefully planning and implementing treatment policies to manage high-risk patients requiring orthognathic surgery.</p>

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