Author Topic: 3mm step-off in lower jaw post-surgery. What does this mean?  (Read 3176 times)

sanddunes

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3mm step-off in lower jaw post-surgery. What does this mean?
« on: September 03, 2013, 03:34:29 PM »
I went to the hospital records office today and got all records from my surgery and hospital stay. 

For those of you who have followed my story at all, you know I had to have a 2nd surgery to remove what they claimed was a metal bracket that was left in my mouth during the surgery. 

After looking at the CT Scan report which they used to determine where the "metal bracket" was left during surgery, two things were disconcerting for me.

1)  The CT report says "There is a step-off of the right parasymphseal osteotomy of approximately 3mm which would correspond to approximately a half width of the mandible.  The left parasymphseal osteotomy demonstrates no step-off or misalignment."

So wtf does that mean?  They misaligned the right side?  Why have they never mentioned anything about this to me?  Did they fix this during the second surgery, or is the misalignment still there? 

2)  "There is a 7mm x 4mm metallic foreign body just to the right and superior to the right submandibular gland."

7mm x 4mm seems WAY bigger than a metal braces bracket.  So what exactly DID they leave in me during the first surgery?  Did they lie to me about it being a metal braces bracket that popped off the tooth during surgery? 

I have an appointment tomorrow that I will be asking for an explanation of the above.  But does anybody know what the 3mm step-off means.  Is it something I will need yet another surgery to correct?

overbiter

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Re: 3mm step-off in lower jaw post-surgery. What does this mean?
« Reply #1 on: September 03, 2013, 04:00:54 PM »
I'm not an expert, but I think a step-off is where there is a significant deviation between surface planes of the ajoining bone segments at the osteotomy site. Looks a bit like a step, like if you cut a plank of wood in half and then shunted the two pieces together without lining them up properly. I think significant deviations are more likely to lead to deformities after surgery because the bone won't completely smooth them out as it heals. I don't see why you should have a step-off on one side, unless your jaw was wonky before the surgery. Is your jaw straight now?

Maybe the metal left in your body was a bracket of some kind. Either that or it was the head for some kind of surgical tool, like a saw or a drill etc.

sanddunes

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Re: 3mm step-off in lower jaw post-surgery. What does this mean?
« Reply #2 on: September 03, 2013, 04:16:48 PM »
I'm not an expert, but I think a step-off is where there is a significant deviation between surface planes of the ajoining bone segments at the osteotomy site. Looks a bit like a step, like if you cut a plank of wood in half and then shunted the two pieces together without lining them up properly. I think significant deviations are more likely to lead to deformities after surgery because the bone won't completely smooth them out as it heals. I don't see why you should have a step-off on one side, unless your jaw was wonky before the surgery. Is your jaw straight now?

Maybe the metal left in your body was a bracket of some kind. Either that or it was the head for some kind of surgical tool, like a saw or a drill etc.

1)  Before surgery I had no jaw assymetry, so it seems like something they screwed up.  The CT report says that there is no misalignment on the left side, but the right is off by 3mm.  I am just really upset that they never even mentioned this to me.  They have been acting like everything went perfect!  I did have a second surgery, so it is possible that they fixed this during the second surgery and never told me.  Right now I still have swelling, so it is hard to see if there is any unevenness on the right side.

2)  I am pretty sure a metal bracket is not 7mm long x 4mm wide.  A bracket seems like it would be 2mm x 2mm or so.  I think it is possible they did leave some kind of tool in me but didn't want to tell me because of malpractice/lawsuits.