Author Topic: RISK CALCULATIONS  (Read 1051 times)

Rico

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RISK CALCULATIONS
« on: April 03, 2015, 11:01:28 AM »
probably there is no answer for this...but I wonder what you think

Generally I got 2 almost the same surgical plans from the 2 different surgeons - malar osteotomy after overlooked fracture in order to put it in original position + infraorbital nerve decompression

The one is well known in Italy and Europe. I could find opinions (but only from "jaw patients"). I can get there only by a plane
The second one is from Germany . He works in well known huge hospital (3rd place in rank of the hospitals in Germany) 5h by a car from the place where I live. He had a lot of patients (3 months of waiting in the queue) but I can't find opinions at all in any German forum - strange ;)

I saw examples - for both are good. Noone seems to be superior at this point.

Both of them have at least 25y of experience, the first one (Italy) even more, because he is older.  At the same time 2x more expensive

In the first option I will have guarented only 2 night of post op care
in Germany 6 days!

but the most but not big difference is in risk calculation. I need nerve decompression. The first one says I will have only very mild hypoasthesia after surgery for a short time. and as  he exactly said, he doesn't think temporary diploplia will occour after surgery . I have to add here, that most surgeons told me this nerve is relatively easy to decompress

The second one says like this:
Quote
[..] rate of diplopia is low (below 10percent), and of permanent diplopia very low (below 1percent).
[..] with nervdecompression to predict the out come is always difficult:
it may reach from the same status to more hypoaesthesia but also to pain..
As I explained to much mobilization out of scars can worsen the result

the second one (Germany) does CAS - computer assisted surgery (navigation to check bone position). - it's helpful but seems not to be superior to manually setting of the bone in right position..just more helpful

additionally
The first one (Italy) uses only MICROplates as an permanent solution - he can remove them only in the case of prolonged complications
The second one uses mostly MINIplates - but he is gonna to remove them after several months

Hard to choose, but the questions is:  From your experience, is it good to care very much about risk calculation? I mean when someone says the risk is little bigger . Can this mean just he is less experienced or in contrast does the other, who claims the risk is lesser , can be just too optimistic ?.

How to determine this ;) ?  probably impossible ?
Despite this "restriction" I wonder what you think .. AND WHAT YOU THINK ABOUT OPINIONS ISSUE (lack of)

BTW who has heard about this ?  https://www.sorg-group.de/index.php?id=25989  what is this ? another maxfac organisation ? not too many ?
« Last Edit: April 03, 2015, 11:27:10 AM by Rico :) »

terry947

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Re: RISK CALCULATIONS
« Reply #1 on: April 03, 2015, 03:33:53 PM »
youre situation is different then what the most of us are going through. It's either you want it or you dont. If you cant talk to anyone who's had it then, its a risk you're going to have to take. If you want to fix this problem, then you have to find a surgeon you trust and who can say that he can fix it with confidence.

Rico

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Re: RISK CALCULATIONS
« Reply #2 on: April 03, 2015, 04:36:14 PM »
easy to say.
to fix it with confidence - there is no such thing when it comes to the nerves :)

however one surgeon told me that he for sure will not damage my nerve too much - only mild damage resulted in slight temporary hypoasthesia
the other tells me it's just a tricky thing, it can be better, it can be worse, no change....just a gamble. I'm not talking even about outcome - wheather procedure will help me - but just the level of the damage just after surgery....

generally I trust both of them, but for me interesting is that one of them is more optimistic (he is also older and I think well known almost in the whole Europe)

I do not need more searching i just have to choose between both of them (eventualy 3rd one, who offers HA implant - sitll not sure)