- Email: [email protected]
Fatal methicillin-resistant Stapylococcus aureus infection after Le Fort I osteotomy: a case report
1080 ICOMS 2011—Abstracts: Oral Papers Surgical planning is carried out, trying to achieve, the correct functional and aesthetic position of the scheletical bases for an optimum projection of the soft tissues. Nevertheless often, additional ancillary procedures are necessary to correct or enhance the results of surgery. Most of the patients are not available for further retouches, giving the instance of the primary surgery a critical unique opportunity for achieving the best possible result. The former will be highly influenced by the skills of the surgeon, speed of the surgery and personal and patient aesthetic preferences. We present our experience in the area describing the possible procedures to be combined and final results in our hands. Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.182
182 Analysis of craneocervical posture measured in lateral ceph of patients treated with orthognathic surgery T. de Mayo 1,∗ , P. Luongo 2 Orthodontics, Universidad Finis Terrae, Rehabilitación Oral y Maxilofacial, Santiago, Chile 2 Instituto de Cirugía, Ortodoncia, Rehabilitación Oral y Maxilofacial, Santiago, Chile
1
Objective: The purpose of this study was to analyze the craneocervical posture (Rocabado’s cephalometric analysis), in lateral cephs, of class II and class III patients treated with orthognathic surgery. Material and method: Three lateral cephs, taken to a random sample of 24 subjects treated with orthognathic surgery, were used. The first one was taken a week before surgery (T1), the second one two weeks after (T2), and the third one six-month later (T3). Computer traced cephalograms were obtained and Rocabadoˇıs analysis was performed. Specifically, the craneocervical angle, C0–C1 space, C1–C2 space, and the hyoid triangle, were recorded. Results: Between T1 and T3, class II subjects had an increase in the craneocervical angle and C0–C1 space. In class III patients the craneocervical angle as well as C0–C1 space decreased. All the results were not statistically significant although they did show a clear tendency. The values for the hyoid triangle behaved unpredictably. Conclusion: Results suggest that in those subjects who presented a decreased
craneocervical angle before surgery (posterior head rotation), a normal occipitalatlas relationship was cephalometrically measured after surgery. The same was true for skeletal class III individuals who reduced their rectified cervical spine, showing proper craneocervical relationship after surgery. Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.183
183 Fatal methicillin-resistant Stapylococcus aureus infection after Le Fort I osteotomy: a case report J.A. Smith Oral and Maxillofacial Surgery, Oregon Health and Science University, Portland, OR, USA
Methicillin-resistant Staphylococcus aureus (MRSA) was first recognized in 1961 and since then, it has caused countless infections and deaths worldwide. In the early 1980s, community acquired strains of MRSA emerged in addition to the previously recognized hospital acquired strains. The use or over-use of antibiotics has contributed to the development of, and selection of, these resistant strains. Fortunately, MRSA complication of oral and maxillofacial surgery procedures is not common. However, when MRSA does complicate a procedure, the effects can be devastating. A case will be herein presented of a Le Fort I osteotomy complicated by a fatal post-operative disseminated MRSA infection. The patient’s clinical course will be described as well as potential contributing factors to her death. A discussion of the use of antibiotics in orthognathic surgery will be included. Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.184
184 Postoperative stability after SSRO with posterior bending osteotomy of distal segment to minimize condylar torque in facial asymmetry S.J. Hwang ∗ , H.J. Yang OMFS, Seoul National University Dental Hospital, School of Dentistry Seoul National University, Seoul, Republic of Korea
Purpose: This study was to evaluate bone healing and postoperative stability after posterior bending osteotomy (PBO)
of distal segment in SSRO to minimize interferences between proximal and distal segments, and to evaluate the usefulness of PBO application in facial asymmetry. Methods: PBO was done to minimize the interferences between proximal and distal segment after mandibular split by BSSRO patients with facial asymmetry (n = 13), while grinding method was used in minor interferences (n = 9). Preoperative, immediate postoperative, 6 months postoperative PA and lateral cephalograms were evaluated. The changes of mention on PA cephalograms and B point on lateral cephalograms were calculated for evaluating postoperative stability of mandible and statistically analyzed. In addition, the adaptation and bone healing of PBO segment was assessed by 3 months-postoperative CT image and 3D reconstruction using Mimics 13.0 (Materialise NV, Belgium). Results: The postoperative stability on PA and lateral cephalograms did not show statistically significant difference between PBO and grinding method. 11 of 13 patients with PBO showed proper bone healing. In cases of non-fixation of PBO segment with positioning screw (n = 2) bone healing was poor, even though the PBO segments were well-maintained at desirable position. Conclusion: PBO group showed favorable postoperative stability and satisfactory bone healing as well. Therefore, PBO could be suggested as a stable technique to minimize the interferences between proximal and distal segment in BSSRO of facial asymmetry patients. Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.185
185 The effect of maxillary advancement on velopharyngeal insufficiency in cleft patients F. Uribe 1,∗ , L. Castellón 1,2,3 , ˜ 1,3 , J. Mayorga 1,2 , R. Farina M. Palomares 4 1 Oral Maxillofacial Surgery, Universidad Mayor, Chile 2 Oral Maxillofacial Surgery, Hospital Dr. Luis Calvo Mackenna, Chile 3 Oral Maxillofacial Surgery, Hospital Exequiel Gonzalez Cortés, Chile 4 Speech-Language Pathology, Hospital Dr. Luis Calvo Mackenna, Santiago, Chile
Midface hypoplasia is a common developmental problem in cleft palate patients, 30–40% of these patients requires surgery during adolescence. Generally with the maxillary advancement, the soft palate
182 Analysis of craneocervical posture measured in lateral ceph of patients treated with orthognathic surgery T. de Mayo 1,∗ , P. Luongo 2 Orthodontics, Universidad Finis Terrae, Rehabilitación Oral y Maxilofacial, Santiago, Chile 2 Instituto de Cirugía, Ortodoncia, Rehabilitación Oral y Maxilofacial, Santiago, Chile
1
Objective: The purpose of this study was to analyze the craneocervical posture (Rocabado’s cephalometric analysis), in lateral cephs, of class II and class III patients treated with orthognathic surgery. Material and method: Three lateral cephs, taken to a random sample of 24 subjects treated with orthognathic surgery, were used. The first one was taken a week before surgery (T1), the second one two weeks after (T2), and the third one six-month later (T3). Computer traced cephalograms were obtained and Rocabadoˇıs analysis was performed. Specifically, the craneocervical angle, C0–C1 space, C1–C2 space, and the hyoid triangle, were recorded. Results: Between T1 and T3, class II subjects had an increase in the craneocervical angle and C0–C1 space. In class III patients the craneocervical angle as well as C0–C1 space decreased. All the results were not statistically significant although they did show a clear tendency. The values for the hyoid triangle behaved unpredictably. Conclusion: Results suggest that in those subjects who presented a decreased
craneocervical angle before surgery (posterior head rotation), a normal occipitalatlas relationship was cephalometrically measured after surgery. The same was true for skeletal class III individuals who reduced their rectified cervical spine, showing proper craneocervical relationship after surgery. Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.183
183 Fatal methicillin-resistant Stapylococcus aureus infection after Le Fort I osteotomy: a case report J.A. Smith Oral and Maxillofacial Surgery, Oregon Health and Science University, Portland, OR, USA
Methicillin-resistant Staphylococcus aureus (MRSA) was first recognized in 1961 and since then, it has caused countless infections and deaths worldwide. In the early 1980s, community acquired strains of MRSA emerged in addition to the previously recognized hospital acquired strains. The use or over-use of antibiotics has contributed to the development of, and selection of, these resistant strains. Fortunately, MRSA complication of oral and maxillofacial surgery procedures is not common. However, when MRSA does complicate a procedure, the effects can be devastating. A case will be herein presented of a Le Fort I osteotomy complicated by a fatal post-operative disseminated MRSA infection. The patient’s clinical course will be described as well as potential contributing factors to her death. A discussion of the use of antibiotics in orthognathic surgery will be included. Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.184
184 Postoperative stability after SSRO with posterior bending osteotomy of distal segment to minimize condylar torque in facial asymmetry S.J. Hwang ∗ , H.J. Yang OMFS, Seoul National University Dental Hospital, School of Dentistry Seoul National University, Seoul, Republic of Korea
Purpose: This study was to evaluate bone healing and postoperative stability after posterior bending osteotomy (PBO)
of distal segment in SSRO to minimize interferences between proximal and distal segments, and to evaluate the usefulness of PBO application in facial asymmetry. Methods: PBO was done to minimize the interferences between proximal and distal segment after mandibular split by BSSRO patients with facial asymmetry (n = 13), while grinding method was used in minor interferences (n = 9). Preoperative, immediate postoperative, 6 months postoperative PA and lateral cephalograms were evaluated. The changes of mention on PA cephalograms and B point on lateral cephalograms were calculated for evaluating postoperative stability of mandible and statistically analyzed. In addition, the adaptation and bone healing of PBO segment was assessed by 3 months-postoperative CT image and 3D reconstruction using Mimics 13.0 (Materialise NV, Belgium). Results: The postoperative stability on PA and lateral cephalograms did not show statistically significant difference between PBO and grinding method. 11 of 13 patients with PBO showed proper bone healing. In cases of non-fixation of PBO segment with positioning screw (n = 2) bone healing was poor, even though the PBO segments were well-maintained at desirable position. Conclusion: PBO group showed favorable postoperative stability and satisfactory bone healing as well. Therefore, PBO could be suggested as a stable technique to minimize the interferences between proximal and distal segment in BSSRO of facial asymmetry patients. Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.185
185 The effect of maxillary advancement on velopharyngeal insufficiency in cleft patients F. Uribe 1,∗ , L. Castellón 1,2,3 , ˜ 1,3 , J. Mayorga 1,2 , R. Farina M. Palomares 4 1 Oral Maxillofacial Surgery, Universidad Mayor, Chile 2 Oral Maxillofacial Surgery, Hospital Dr. Luis Calvo Mackenna, Chile 3 Oral Maxillofacial Surgery, Hospital Exequiel Gonzalez Cortés, Chile 4 Speech-Language Pathology, Hospital Dr. Luis Calvo Mackenna, Santiago, Chile
Midface hypoplasia is a common developmental problem in cleft palate patients, 30–40% of these patients requires surgery during adolescence. Generally with the maxillary advancement, the soft palate