Incidence of Pneumothorax Experienced After Orthognathic Surgery

The purpose of this study is to evaluate the frequency of pneumothorax following orthognathic surgery and describe its clinical presentation. A retrospective analysis of a hospital database was carried out on consecutive patients with normal presurgical clinical assessment, laboratory findings, and chest X-ray who underwent orthognathic surgery from January 2007 to September 2018 in the Department of Oral and Craniomaxillo-facial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Two patients (0.038%), 1 male (age 20 years) and 1 female (age 32 years), complained of respiratory difficulty and chest pain and were clearly diagnosed with postoperative pneumothorax by radiographic chest X-rays from a sample of 5229 consecutive patients during the study period. Intercostal drainage under local anesthesia was performed immediately and the treatment effects for both patients were satisfactory. The present study findings indicate that although orthognathic surgeries can be safely performed in patients with craniofacial anomalies, some unexpected complications such as pneumothorax may occur. Therefore, accurate postoperative follow-up must be done in every patient to monitor possible clinical complications. Patients who experience respiratory difficulty and postoperative chest pain may have pneumothorax, and once it is diagnosed, treatment should be promptly carried out to eliminate further severe sequelae.