Combitube insertion in the situation of acute airway obstruction after extubation in patients underwent two-jaw surgery

The Combitube is an emergency airway-maintaining device, which can supply oxygen to dyspneic patients in emergency situations following two-jaw surgery. These patients experience difficulty in opening the mouth or have a partially obstructed airway caused by edema or hematoma in the oral cavity. As such, they cannot maintain the normal airway. The use of a Combitube may be favorable compared to the laryngeal mask airway because it is a thin and relatively resilient tube. A healthy 24-year-old man was dyspneic after extubation. Oxygen saturation fell below 90% despite untying the bimaxillary fixation and ambubagging. The opening of the mouth was narrow; thus, emergency airway maintenance was gained by insertion of a Combitube. The following day, a facial computer tomography revealed that the airway space narrowing was severe compared to its pre-operational state. After the swelling subsided, the patient was successfully extubated without complications.

A Case of Nasolacrimal Duct Obstruction after Two-Jaw Surgery

PURPOSE: To describe a case of nasolacrimal duct obstruction after two-jaw surgery. CASE SUMMARY: A 22-year-old woman presented with a 1-year history of epiphora after two-jaw surgery. Orbital CT showed 5 mm of focal soft tissue at the level of the distal nasolacrimal duct. Dacryocystography showed complete obstruction at the nasolacrimal duct level. Thus a nasolacrimal duct obstruction was diagnosed by physical and radiologic examination. CONCLUSIONS: In patients with epiphora who have undergone two-jaw surgery, precise examination and treatment is required in order to exclude nasolacrimal duct obstruction.

Soft tissue changes associated with ASO/BSSRO and Le Fort I/BSSRO in skeletal Class III malocclusion with upper lip protrusion / 대한치과교정학회지

OBJECTIVE: The objective of this study was to compare maxillary soft tissue changes and their relative ratios to hard tissue changes after anterior segmental osteotomy (ASO)/bilateral sagittal split ramus osteotomy (BSSRO) and Le Fort I/BSSRO in skeletal Class III malocclusion with upper lip protrusion. METHODS: The study sample comprised the ASO/BSSRO group (n = 14) and the Le Fort I/BSSRO group (n = 15). The Le Fort I/BSSRO group included cases of maxillary posterior impaction only. Lateral cephalograms were taken 2 months before and 6 months after surgery. Linear and angular measurements were performed. RESULTS: The anterior maxilla moved backward in both groups after surgery, however the amount of change was significantly larger in the ASO/BSSRO group (p < 0.01). The ratios of hard to soft tissue change were 79% (SLS to A point), 80% (LS to A point) in the ASO/BSSRO group, and 15% (SLS to A point), 68% (LS to A point) in the Le fort I/BSSRO group. In addition, there was a 3.23degrees increase of the occlusal plane in the Le Fort I/BSSRO group. CONCLUSIONS: When two-jaw surgery is indicated in skeletal Class III patients with protrusive lips, ASO may be a treatment of choice for cases with more severe upper lip protrusion, while Le Fort I with posterior impaction may be considered if an increase of occlusal plane angle is required.

Unilateral pulmonary edema after two-jaw surgery: A case report / 대한마취과학회지

Pulmonary edema is usually bilateral, but can be uncommonly unilateral. Although unilateral pulmonary edema (UPE) can occur owing to various etiologies, it usually occurs at a patient who has an underlying defect or abnormality in the cardiopulmonary system except a case of negative-pressure pulmonary edema. Especially UPE following general anesthesia is a rare complication in a healthy patient. Re-expansion pulmonary edema (REPE) as a cause of UPE mostly occurs when a chronically collapsed lung is rapidly re-expanded after pneumothorax. There are some reports associated with REPE following one-lung ventilation used to facilitate surgery, in which there is no chronically collapsed lung. There are, however, little reported cases of a more acute form of this complication following re-expansion after atelectasis due to only several minutes of an inadvertent main stem bronchial intubation during operation. A report of the occurrence of UPE in a healthy, young male undergoing two-jaw surgery is described.

The effect of pre-operative maxillary occlusal plane angle to post-operative skeletal stability after two-jaw surgery

Case report of pulmonary edema during two jaw surgery

Fabrication of surgical splint by using of surgical jaw relator

Two-jaw surgery by use of Surgical Jaw Relator / 대한치과교정학회지

The contemporary two-jaw surgical approach usually involves a Le Fort osteotomy of the maxilla and a ramal osteotomy of the mandible with 3-dimensional repositioning of the jaws as well as the occlusal planes. After making the surgical treatment plan, the surgical movements are duplicated in the model surgery. During this procedure, reference points and lines are drawn on the base of the models over the dental arch, and sawcuts are made according to these marked osteotomy lines. This technique, however, has been found to be inexact, especially when the jaws are moved in several dimensions simultaneously. To overcome this, different methods have been developed for an accurate repositioning of the jaws as planned. A new appliance, Surgical Jaw Relator, has been devised by the author for the simple 3-dimensional relocation of the upper and lower models, resulting in the easy construction of the splints such as centric relation splint, intermediate and final splint. This article describes an introduction and a clinical application of this appliance. Through the application of this system to the orthognathic cases including two-jaw surgery, it is proved that the new device is very clinically useful.

A Case of Severe Scleroderma en Coup de Sabre with Ipsilateral Body Atrophy

Linear scleroderma is a variant of localized scleroderma which may occur in the head, trunk and extremities, affecting variously the skin, subcutaneous tissue, muscle, cartilage and bone. Particularly, scleroderma en coup de sabre is the descriptive term denoting linear scleroderma of the frontoparietal area of the scalp and face. We report a case of severe scleroderma en coup de sabre with ipsilateral body atrophy(total hemiatrophy) who underwent multidisciplinary assessment and required both two-jaw surgery and groin free flap to correct the underlying skeletal deformities and augment the facial soft tissues. The reason for classifying this as a case of scleroderma en coup de sabre in preference to Parry-Romberg syndrome is because of the striking clinical features seen in this patient.

Stability Of Two-Jaw Surgery And Single Mandibular Surgery In Mandibular Prognathism

6months); were analyzed by linear measurement to evaluate changes in position (hard tissue B, Pogonion point)and compare relapse both group.The results obtained were as follows ; In view of B-point, the horizontal relapse rate of single mandibular surgery was 10.17%at post-op 1month,12.52%at post-op 3months,13.01%at post-op 6months and two-jaw surgery was 10.23%at post-op 1month,11.84% at post-op 3months,12.97%at post-op 6months. the horizontal relapse rates of Pogonion point were 10.78% at post-op 1month,12.21% at post-op 3months,12.98%at post-op 6months in single mandibular surgery and those were 10.27%at post-op 1month,11.33% at post-op 3months, 12.01%at post-op 6months in two-jaw surgery. In terms of vertical relapse rate, rates of B point were 22.96%at post-op 1month,28.30%at post-op 3months,29.56%at post-op 6months in single mandibular surgery and 21.14%at post-op 1month, 25.45% at post-op 3months,28.86% at post-op 6months in two-jaw surgery.Those of Pogonion point were 26.63%at post-op 1month,28.40% at post-op 3months,29.29% at post-op 6months in single mandibular surgery and 20.20%at post-op 1 month, 25.44% at post-op 3 months, 27.68% at post-op 6months in two-jaw surgery. There were no statistical difference between single mandibular surgery and two-jaw surgery in mandibular stability.

Stability of two-jaw surgery for mandibular prognathism