Titanium miniplate removal after joint orthodontic-orthognathic surgery treatment: a 10-year retrospective hospital-based audit.

INTRODUCTION: The reported incidence of titanium miniplate removal after orthognathic surgery varies widely, making delivery of risk information to patients problematic. This variation relates to potential biases introduced during the study design, for example, with the pooling of different patient types, creating heterogeneous study samples. This study reduces sampling bias by limiting the cohort to only consecutive orthognathic cases. The primary aim of the study was to identify the incidence of miniplate removal following orthognathic surgery. The secondary aim was to assess the indications and any risk factors for miniplate removal. METHODS: Data from the clinical records of 907 orthognathic surgery cases treated within a centralised oral and maxillofacial hospital service over a 10-year period were collected by two operators and analysed. Every identified case qualified for inclusion. Patient demographics (age, sex, medical comorbidity, smoking), operations (type of surgery, duration, third molar removal, complications) and the indication, timing and site of miniplate removal were analysed. RESULTS: Only 19 patients required postoperative miniplate removal, with the most common indication being infection (63%). There was no significant difference in any of the factors assessed except that significantly more miniplates were removed from female patients (68%) (p<0.001) and from mandibular sites (84.2%) (p=0.003). CONCLUSIONS: The incidence of miniplate removal for this sample was 2.1%. Female sex and miniplate location in the mandible were the only statistically significant risk factors for miniplate removal.

[Vascular hemiballismus due to extraluysian lesions]. / Hémiballisme vasculaire par atteinte extraluysienne.

INTRODUCTION: Hemiballismus is a very rare disorder; less than 7% of all hyperkinetic disorders. Classically, a lesion of the contralateral corpus Luysii is involved. We report a case of hemiballismus due to an extraluysian lesions and discuss the underlying pathophysiology. CASE REPORT: A 74-year-old women, with a history of diabetes and hypertension, developed left-sided hemiballismus one week before admission. The brain MRI showed a right lenticular nucleus hematoma with vascular leucoencephalopathy. The patient was given haloperidol and recovered well. The brain MRI showed the integrity of both corpus Luysii. CONCLUSION: Hemiballismus has been classically characterized as pathognomonic of a lesion in the contralateral corpus Luysii. However, many cases due to an extraluysian lesion of the striatum, caudate or thalamus have been reported recently. Prognosis is benign in most cases.