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Contrast-enhanced computed tomography of retromandibular vein position and course patterns relative to the mandible during sagittal split ramus osteotomy.
Sugahara, Keisuke; Oiwa, Koki; Matsunaga, Satoru; Odaka, Kento; Hirouchi, Hidetomo; Koyachi, Masahide; Kasahara, Norio; Tachiki, Chie; Nishii, Yasushi; Wolff, Klaus-Dietrich; Katakura, Akira.
Afiliación
  • Sugahara K; Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Tokyo, Japan.
  • Oiwa K; Oral Health Science Center, Tokyo Dental College, Tokyo, Japan.
  • Matsunaga S; Department of Oral and Maxillofacial Surgery, Technical University Munich, Klinikum Rechts der Isar, München, Germany.
  • Odaka K; Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Tokyo, Japan.
  • Hirouchi H; Oral Health Science Center, Tokyo Dental College, Tokyo, Japan.
  • Koyachi M; Department of Anatomy, Tokyo Dental College, Tokyo, Japan.
  • Kasahara N; Oral Health Science Center, Tokyo Dental College, Tokyo, Japan.
  • Tachiki C; Department of Oral and Maxillofacial Radiology, Tokyo Dental College, Tokyo, Japan.
  • Nishii Y; Department of Anatomy, Tokyo Dental College, Tokyo, Japan.
  • Wolff KD; Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Tokyo, Japan.
  • Katakura A; Oral Health Science Center, Tokyo Dental College, Tokyo, Japan.
Quant Imaging Med Surg ; 14(2): 1652-1659, 2024 Feb 01.
Article en En | MEDLINE | ID: mdl-38415165
ABSTRACT

Background:

Sagittal split ramus osteotomy is an established procedure used in oral and maxillofacial surgery. Major bleeding is representative intraoperative complication involves vessels such as the inferior alveolar, facial, and maxillary arteries and accompanying veins, in particular the retromandibular vein (RMV). We previously described the RMV course patterns using embalmed cadavers. However, owing to the possible influence of formalin fixation and unclear skeletal classification of the jaws, the present study aimed to use contrast-enhanced computed tomography to confirm the RMV in patients with defined jaw deformities.

Methods:

Twenty patients with orthognathic jaw deformities (40 sides) were included. The RMV and the lateral and posterior views of the mandible were evaluated using contrast-enhanced computed tomography. Course patterns and RMV positions were classified as previously reported.

Results:

Three patterns were identified in the lateral view. Type A RMV posterior to the posterior border of the ramus (n=25; 62.5%). Type B adjoining the posterior border of the ramus (n=12; 30.0%). Type C anterior to the posterior border of the ramus (n=3; 7.5%). Five course patterns were identified in the posterior view. Pattern I rectilinear course running medial to the posterior border of the ramus (n=3; 7.5%). Pattern II diagonal course running medially from immediately posterior to posterior border of the ramus (n=11; 27.5%). Pattern III rectilinear course running immediately posterior to the posterior border of the ramus (n=12; 30.0%). Pattern IV diagonal course running from lateral to medial relative to the posterior border of the ramus (n=8; 20.0%). Pattern V diagonal course running from lateral to immediately posterior relative to the posterior border of the ramus (n=6; 15.0%). In the no-course pattern group, the RMV inferior to the lingula was lateral to its position and superior to that of the lingula. In half of the cases, the left and right sides exhibited different running patterns. We observed no correlation between the skeletal patterns of jaw deformities and the course of the RMV.

Conclusions:

Type B/Pattern II that runs in a straight line bordering the posterior margin of the ramus requires the most attention during surgery. These findings suggest the possibility of predicting intraoperative bleeding risk.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Quant Imaging Med Surg Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: China
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Quant Imaging Med Surg Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: China