Complications Following Orthognathic Surgery in Patients with Cleft Lip and/or Palate: A single-centre retrospective analysis of 57 consecutive patients

Abstract

Objectives: The most prevalent craniofacial abnormality in infants is cleft lip and/or palate (CL/P). Orthognathic surgery is necessary for 25–60% of patients in order to enhance face aesthetics and masticatory function. Nevertheless, there is a lack of defined complication profiles in this particular population. Thus, this study aimed to describe the spectrum and frequency of complications following orthognathic surgery in CL/P patients at a tertiary care referral centre. Methods: This retrospective cohort study included consecutive CL/P patients who underwent orthognathic surgery at Al Nahda Hospital, Muscat, Oman, between 2008–2022. Variables analysed included demographics, procedure type, length of stay and predefined complications (intraoperative haemorrhage, transfusion, dental injury, wound dehiscence, relapse, temporomandibular joint [TMJ] disorder, repeat surgery and condylar resorption). Complications were graded using the Clavien–Dindo Classification (CDC) and 95% Wilson confidence intervals (CI) were calculated. Results: A total of 57 patients were included in this study. Nearly half of patients underwent Le Fort I osteotomy (45.6%), followed by bimaxillary (31.6%), Le Fort I + genioplasty (10.5%), trimaxillary (8.8%), BSSO (1.8%) and BSSO + genioplasty (1.8%). Overall, 19 patients developed complications, most of which were CDC Grade III. The most frequent complication was relapse (10.5%), followed by TMJ disorder (5.3%), repeat surgery (5.3%), dental injury (3.5%), intraoperative haemorrhage (3.5%), wound dehiscence (1.8%), transfusion (1.8%) and there were no cases of condylar resorption. Conclusions: Complications developed in one-third of patients who underwent orthognathic surgery; however, most were manageable. Relapses were the most frequent complication and there were no life-threatening complications (CDC Grade IV–V), demonstrating overall safety of the procedure in CL/P patients.