Complication Prevention and Care After Midface Osteotomies

Postoperative complications can be divided into immediate complications during the termination of the anesthesia and the first 3 h thereafter (emergency), as well as complications that can occur in the first 12–24 h after the end of the operation, when the patient is usually on the normal ward or at home. The most serious complications affect the functions of the lungs, heart, and all forms of weaning disorders, in which the patient becomes a danger to himself/herself (Van Merkesteyn et al., Int J Oral Maxillofac Surg 16:665–70, 1987). After orthognathic surgery, various complications can occur and cause serious situations. To avoid postoperative respiratory complications, all patients in this treatment group require critical and professional support in the immediate postoperative phase. Complications related to the respiratory system include airway obstruction, hypoventilation, tachypnea, tracheal swelling, bronchospasm, aspiration, and rarely spontaneous atelectasis or even a pneumothorax. The preoperative assessment of the airway space requires interdisciplinary cooperation between surgeons and anesthesiologists to avoid unpleasant and almost unresolvable airway constrictions at the end of a Le Fort procedure. Checklists will help to avoid these complications (Choi et al., Maxillofac Plast Reconstr Surg. 36:185–191, 2014; Soydan et al., Int J Oral Maxillofac Surg. 44:1351–4, 2015)).