Availability of autologous transfusion in bilateral sagittal split ramus osteotomy for mandibular prognathism

OBJECTIVE: Autologous transfusion is frequently used with orthognathic surgery. The necessity of autologous transfusion has begun to question alone in bilateral sagittal split ramus osteotomy. The aim of this study was to evaluate the availability of autologous transfusion. METHODS: The chart reviews of sixty patients who had undergone bilateral sagittal ramus osteotomy were done. The subjects were divided into two groups : In experimental group, 30 patients who autodonated 320ml in the preoperative 3 weeks actually received a transfusion in the postoperative 6 hours were included. In control group, 30 patients who underwent the same operation without preoperative donation and any other transfusion were included. Hemoglobin, hematocrit, and changes of these values in both groups were evaluated. RESULTS: 1. From postoperative 3 hours to postoperative 1 day, the increases of hemoglobin(0.8g/dL in experimental group, 0.2g/dL in control group) and hematocrit(0.3% in experimental group, 0.6% in control group) were not statistically significant between both groups. 2. From postoperative 1 day to postoperative 1 week, the increase of hemoglobin(0.6g/dL in experimental group, 0.3g/dL in control group) was not statistically significant between both groups. But the increase of hematocrit(2.5% in experimental group, 1.0% in control group) was statistically significant between both groups over the same period(hematocrit p=0.043). 3. On postoperative 1 week, the values of hemoglobin(12.3% in both groups) and hematocrit(35.6% in experimental group, 36.8% in control group) were not statistically significant between both groups. CONCLUSION : The autologous transfusion in surgery of just a little blood loss was not effective. The most results show that there is little availability of autologous transfusion according to changes of hemoglobin and hematocrit in bilateral sagittal split ramus osteotomy.

Osteoradionecrosis on mandible: A case report and literature review

The osteoradionecrosis of the mandible can be a serious complication of radiotherapy for malignancies of the head and neck. The cause and pathogenesis of osteoradionecrosis are unclear and anecdotal. There are various treatment-, patient- and tumor-related risk factors on development of osteoradionecrosis. The treatment of osteoradionecrosis relies on conservative measures (antibiotics, debridement, irrigation and HBO) and surgical measures (sequestrectomy, marginal resection and segmental resection with or without reconstruction). But the indications are not defined. We present the two cases of patients who were not controlled by conservative treatment but good-resulted by surgical treatment.