RESUMEN
RESUMEN La cirugía ortognática (CO) es un procedimiento quirúrgico que genera pérdida sanguínea intraoperatoria (PSI), motivo por el cual el cirujano bucal y maxilofacial (CBMF) permanentemente está generando nuevas técnicas para controlarla. Objetivo: Determinar los factores asociados a la PSI en CO. Material y Métodos: Estudio retrospectivo, descriptivo transversal y analítico. Se revisaron 60 historias clínicas de pacientes operados de CO que cumplieron los criterios de selección. La variable dependiente fue PSI y las covariables: tipo de CO, operador (Cirujano bucal y Maxilofacial o Residente del programa en CBMF), instrumentos de corte, tiempo operatorio (TO), tiempo de protrombina (TP), tiempo de tromboplastina (TTP), recuento de plaquetas, edad y sexo. Se aplicaron las pruebas estadísticas ANOVA, t de Student, Rho de Spearman y correlación de Pearson. Resultados: Existe asociación estadísticamente significativa entre la PSI con el TO y la relación con el operador (p<0,005) y (p<0,001). Además, existe correlación directa entre PSI y TO (p<0,05). Conclusiones: El operador y el TO son variables asociadas directamente a la PSI en las CO.
ABSTRACT Orthognathic surgery is a surgical procedure that generates intraoperative blood loss, which is why the oral and maxillofacial surgeon is constantly generating new techniques and technologies for the reduction of intraoperative blood loss. Objective: To determine the factors associated with intraoperative blood loss in orthognathic surgery. Material and Methods: It is a retrospective, descriptive, cross-sectional and analytical study. Sixty medical records of patients operated of orthognathic surgery were reviewed that met the selection criteria. The dependent variable was intraoperative blood loss and the covariates: type of orthognathic surgery, operator: Maxillofacial surgeon or resident of the program in maxillofacial surgeon, cutting instruments, operative time, prothrombin time, thromboplastin time, platelet count, age and sex. The statistical tests ANOVA, Student's t, Spearman's Rho and Pearson's correlation were applied. Results: There is a significant difference in Intraoperative blood loss and operative time in relation to the operator who performed the surgery (p<0.005) and (p<0.001) there is also a direct correlation between intraoperative blood loss and operative time (p<0.05). Conclusions: The operator and the TO are variables directly associated with the PSI in the orthognathic surgery.
RESUMEN
OBJETIVOS: Comparar la variación de la dimensión del espacio orofaríngeo (EO) en el prequirúrgico, postquirúrgico inmediato y postquirúrgico de 5 a 24 meses después de la cirugía de retroceso mandibular (CRM). MATERIALES Y MÉTODOS: Se evaluaron las radiografías cefalométricas prequirúrgicas, postquirúrgicas inmediatas y postquirúrgicas de 5 a 24 meses de 20 pacientes con CRM del Servicio de Cirugía Oral y Maxilofacial de dos instituciones. Se cuantificó la dimensión del EO en diferentes momentos. RESULTADOS: No se encontraron diferencias de significación entre la cantidad de retroceso mandibular y la variación de la dimensión del EO. CONCLUSIONES: Existe una leve disminución de la dimensión del EO después de la CRM. No son estadísticamente significantes entre los momentos de evaluación. No se encontró correlación entre el retroceso mandibular y la disminución del EO
OBJECTIVE: The aim of this study was to compare the variation in the size of the oropharyngeal space (OS) in the preoperative, immediate postoperative and post-operative 5 to 24 months according to the amount of mandibular setback. MATERIAL AND METHOD: Variation were evaluated on cephalometric radiographs taken few days before the surgery (Rx1), immediate postoperative (Rx2) and postoperative long time (5 to 24 months) (Rx3). The subjects were 20 patients (18 - 36 years) in whom dentofacial deformity class III was corrected by bilateral sagittal split ramus osteotomy setback. Surgery was done in two Oral and Maxillofacial specialized institutions, since 2003 to 2010. We examined the size of the oropharyngeal space at different times before and after mandibular setback surgery. RESULTS: These shows no significant difference between the amount of mandibular setback and decrease the size of the oropharyngeal space. It was determined that the oropharyngeal space immediately after surgery increases and decreases over time as a result of soft and hard tissue adaptation. CONCLUSIONS: We conclude that there is a slight decreased in the anteroposterior dimension of oropharynx after mandibular setback surgery, however the variations is no statistically significant difference between the moments of evaluation (the amount of mandibular recoil and the decrease in OS)