Today many surgical procedures involving head and neck areas can be
performed under local anesthesia and intravenous sedation. The authors
add to this list the sagittal osteotomies of the mandibular rami,
thereby avoiding the need for general anesthesia and a hospital stay.
The authors designed a protocol to be followed in a multicenter study
(Milan and Barcelona) and applied it in 35 clinical cases with Class II
malocclusion. The surgical procedure was performed with the Monitored
Anesthesia Care technique, a combination of regional anesthesia
and intravenous sedation.The results were good in all the clinical cases;
skeletal correction of Class II was achieved in all patients and there
were no intraoperative or postoperative complications. The major advantage
of this technique is the functional control of the temporomandibular
joint, which avoids displacements caused by gravity and
the muscular relaxation commonly seen under general anesthesia. Furthermore,
this protocol allows a reduction in costs, duration of surgery,
and patient morbidity and convalescence.When this technique is accepted
without hesitation, all Class II patients with only mandibular deficiency
deformity may be treated in the most suitable way, thus providing
the most satisfactory outcomes for the patient, orthodontist,
and surgeon.
|