Peripheral facial nerve palsy following orthognathic surgery is a rare complication. We discuss the incidence of this complication, its possible causes, subsequent treatment and ultimate outcomes.
A total of 910 patients underwent orthognathic surgery in our department during the period from 2001 to 2015. Five (0.55%) of those patients had peripheral facial nerve palsy postoperatively. The postoperative day when facial nerve palsy occurred ranged from day 1 to day 13. All of the cases were unilateral and included lip motility disturbance, difficulty in closing the eyes and inability to wrinkle the forehead. All of the patients received medication with an adrenocortical steroid and vitamin B12. Stellate ganglion block and physical therapy were also used for the patients who had moderate to severe facial nerve palsy. Complete recovery was achieved in all but one of the patients, in whom slight palsy remained. There were several possible causes of facial nerve palsy including abnormal bleeding, postoperative swelling, and handling of operating instruments.
In conclusion, peripheral facial nerve palsy after orthognathic surgery is relatively rare. If it occurs, however, complete recovery can be expected in most cases.
