Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2017 Nov 7;13(1):19.
doi: 10.1186/s13005-017-0153-1.

The influence of dexamethasone on postoperative swelling and neurosensory disturbances after orthognathic surgery: a randomized controlled clinical trial

W Semper-Hogg  1 , M A Fuessinger  2 , T W Dirlewanger  2 , C P Cornelius  3 , M C Metzger  2
Affiliations
Randomized Controlled Trial

The influence of dexamethasone on postoperative swelling and neurosensory disturbances after orthognathic surgery: a randomized controlled clinical trial

W Semper-Hogg et al. Head Face Med. .

Abstract

Background: Orthognathic surgery is associated with considerable swelling and neurosensory disturbances. Serious swelling can lead to great physical and psychological strain. A randomized, prospective, controlled clinical trial was realized in order to evaluate the effect of a preoperative intravenous dexamethasone injection of 40 mg on postoperative swelling and neurosensory disturbances after orthognathic surgery.

Methods: Thirty-eight patients (27 male and 11 female) patients, all with the indication for an orthognathic surgery, were enrolled in this study (mean age: 27.63 years, range: 16-61 years) and randomly divided into two groups (study group/ control group). Both groups underwent either maxillary and/or mandibular osteotomies, resulting in three subgroups according to surgical technique (A: LeFort I osteotomy, B: bilateral sagittal split osteotomy (BSSO), C: bimaxillary osteotomy). The study group received a single preoperative intravenous injection of 40 mg dexamethasone. Facial edema was measured by 3D surface scans on the 1st, 2nd, 5th, 14th and 90th postoperative day. Furthermore, neurosensory disturbances on the 2nd, 5th, 14th and 90th postoperative day were investigated by thermal stimulation.

Results: Facial edema after LeFort I osteotomy, BSSO and bimaxillary osteotomy showed a significant decrease in the study group compared to the control group (P = 0.048, P = 0.045, P < 0.001). The influence of dexamethasone on neurosensory disturbances was not significant for the inferior alveolar nerve (P = 0.746) or the infraorbital nerve (P = 0.465).

Conclusions: Patients undergoing orthognathic surgery should receive a preoperative injection of dexamethasone in order to control and reduce edema. However, there was no influence of dexamethasone on reduction of neurosensory disturbances.

Trial registration: DRKS00009033 .

Keywords: Dexamethasone; Edema; Glucocorticoids; Neurosensory disturbance; Orthognathic surgery; Swelling.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

Germany Protocol number: EK 4 / 14, Local ethics committee of the Albert-Ludwigs-Universität Freiburg.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Consort Statement Flow Diagram
Fig. 2
Fig. 2
Development of swelling – D1 = first postoperative day, D2 = second postoperative day, D5 = fifth postoperative day, D14 = fourteenth postoperative day, D90 = ninetieth postoperative day (reference scan)
Fig. 3
Fig. 3
Textured face scan of D90 (grey) and polygonal mesh of D1 (red) of a female patient after bilateral sagittal split osteotomy (BSSO) demonstrating the areas with less (nose and infraorbital area, right) or maximum swelling (paramandibular area, left, and neck)
Fig. 4
Fig. 4
Postoperative swelling following LeFort I osteotomy (D1-D4) with and without a preoperative dexamethasone injection
Fig. 5
Fig. 5
Postoperative swelling following bilateral sagittal split osteotomy (BSSO) (D1-D4) with and without a preoperative dexamethasone injection
Fig. 6
Fig. 6
Postoperative swelling following bimaxillary osteotomy (D2-D4) with and without a preoperative dexamethasone injection
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Schaubel HJ. The local use of ice after orthopedic procedures. Am J Surg. 1946;72:711–714. doi: 10.1016/0002-9610(46)90347-9. - DOI - PubMed
    1. Rana M, Gellrich N-C, von See C, Weiskopf C, Gerressen M, Ghassemi A, Modabber A. 3D evaluation of postoperative swelling in treatment of bilateral mandibular fractures using 2 different cooling therapy methods: a randomized observer blind prospective study. J Cranio-Maxillofac Surg. 2013;41:e17–e23. doi: 10.1016/j.jcms.2012.04.002. - DOI - PubMed
    1. Dan AEB, Thygesen TH, Pinholt EM. Corticosteroid Administration in Oral and Orthognathic Surgery: a systematic review of the literature and meta-analysis. J Oral Maxillofac Surg. 2010;68:2207–2220. doi: 10.1016/j.joms.2010.04.019. - DOI - PubMed
    1. Nauck M, Karakiulakis G, Perruchoud AP, Papakonstantinou E, Roth M. Corticosteroids inhibit the expression of the vascular endothelial growth factor gene in human vascular smooth muscle cells. Eur J Pharmacol. 1998;341:309–315. doi: 10.1016/S0014-2999(97)01464-7. - DOI - PubMed
    1. Widar F, Kashani H, Alsén B, Dahlin C, Rasmusson L. The effects of steroids in preventing facial oedema, pain, and neurosensory disturbances after bilateral sagittal split osteotomy: a randomized controlled trial. Int J Oral Maxillofac Surg. 2015;44:252–258. doi: 10.1016/j.ijom.2014.08.002. - DOI - PubMed

Publication types

MeSH terms