Author Topic: (LOTS of) Complications associated with orthognathic surgery  (Read 24481 times)

GJ

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Re: (LOTS of) Complications associated with orthognathic surgery
« Reply #15 on: July 11, 2019, 06:49:44 PM »
OK, saw the YT video.  I looked up name 'Justin Love', which was his real name and found obituary where they said he died in med procedure. But no details.

https://www.peakefh.com/obituary/love-justin

YT video said something about his needing HIP BONE to be harvested for the surgery. So, maybe it was orthopedic surgeon doing the hip harvest? If the artery was from the hip harvest, could have been the femoral artery.

No to the hip harvest. At the time it was all over the news. It was a female orthognatic surgeon. She severed an artery during his jaw surgery.
My guess is there was a settlement because now there's nothing out there. There were not only articles but Yelp reviews bashing her.

OHSU is Oregon. I think he might have been from Washington. But yeah, PNW as I remembered.
Millimeters are miles on the face.

kavan

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Re: (LOTS of) Complications associated with orthognathic surgery
« Reply #16 on: July 11, 2019, 07:06:00 PM »
No to the hip harvest. At the time it was all over the news. It was a female orthognatic surgeon. She severed an artery during his jaw surgery.
My guess is there was a settlement because now there's nothing out there. There were not only articles but Yelp reviews bashing her.

OHSU is Oregon. I think he might have been from Washington. But yeah, PNW as I remembered.

O well, went to orthodoc.aaos.org  (listing of ortho surgeons) before I read your post.  Found one female with Asian name: Susan Lai Williams.
http://orthodoc.aaos.org/SusanWilliamsMD/?_ga=2.162048316.1447606032.1562896375-801270307.1562896375

So, that's not the one either.  Too curious to find out but not getting much from searches.
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GJ

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Re: (LOTS of) Complications associated with orthognathic surgery
« Reply #17 on: July 11, 2019, 07:08:40 PM »
Yeah I think the $ at OSHU scrubbed the internet clean.
There's this post where he talks about his surgery (he might have named the surgeon), but Google cache says the page is gone. http://www.jawsurgeryblog.com/forums/viewtopic.php?t=2365

To me that means there was a $crub.

His sister posted on his video 4 months ago. She might be the only way to find out. I didn't see any contact info.
Millimeters are miles on the face.

kavan

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Re: (LOTS of) Complications associated with orthognathic surgery
« Reply #18 on: July 11, 2019, 07:21:21 PM »
Yeah I think the $ at OSHU scrubbed the internet clean.
There's this post where he talks about his surgery (he might have named the surgeon), but Google cache says the page is gone. http://www.jawsurgeryblog.com/forums/viewtopic.php?t=2365

To me that means there was a $crub.

His sister posted on his video 4 months ago. She might be the only way to find out. I didn't see any contact info.

Ya, I saw the sister's YT post and channel. But she just seems like a pre-teen who might not know doctor's name.
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kavan

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Re: (LOTS of) Complications associated with orthognathic surgery
« Reply #19 on: July 11, 2019, 07:33:16 PM »
Looks to be a teaching hospital. Maybe was a resident or a student.
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PloskoPlus

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Re: (LOTS of) Complications associated with orthognathic surgery
« Reply #20 on: July 11, 2019, 07:34:54 PM »
Looks to be a teaching hospital. Maybe was a resident or a student.
Pretty sure the resident "assisting" my surgeon wrecked my infraorbital nerve.

april

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Re: (LOTS of) Complications associated with orthognathic surgery
« Reply #21 on: July 11, 2019, 09:45:26 PM »
A few years ago when I first heard of Justin's I remember looking it up and IIRC someone said it was the carotid artery. Whichever one it was, the discussion online was it was severed and not noticed (how could it not be noticed?) Someone (a sibling I think) had posted proper updates on either youtube or the other jaw forum at some point.

GJ

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Re: (LOTS of) Complications associated with orthognathic surgery
« Reply #22 on: July 11, 2019, 09:53:11 PM »
A few years ago when I first heard of Justin's I remember looking it up and IIRC someone said it was the carotid artery. Whichever one it was, the discussion online was it was severed and not noticed (how could it not be noticed?) Someone (a sibling I think) had posted proper updates on either youtube or the other jaw forum at some point.

I take it you don't remember the surgeon?
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april

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Re: (LOTS of) Complications associated with orthognathic surgery
« Reply #23 on: July 11, 2019, 10:05:16 PM »
Nah, can't remember her name.

kavan

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Re: (LOTS of) Complications associated with orthognathic surgery
« Reply #24 on: July 12, 2019, 10:04:28 AM »
Some (more) journal articles about artery injuries during oral surgey. Not sure if some of them were due to weird or unpredictable vessel anatomy. But for sure, most due to IATROGENIC INJURIES which means DOCTOR CAUSED injuries.


"Diagnosis and management of blunt carotid artery injury in oral and maxillofacial surgery."

https://www.ncbi.nlm.nih.gov/pubmed/9393397

Distressing to find that's also a risk. In this paper, they track 12 patients in a 2 year period, all of whom had BLUNT injury from the surgery with terrible neurological deficits of those that survived (didn't die from it). They say it's a rare complication. But here, they are talking about BLUNT injury which is different from artery actually being severed which is much worse.
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"Massive Hemorrhage During Oral and Maxillofacial Surgery: Ligation of the External Carotid Artery or Embolization?"

https://www.joms.org/article/S0278-2391(09)00304-8/fulltext
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"Internal carotid artery thrombosis after blunt maxillofacial trauma"

https://www.oooojournal.net/article/0030-4220(91)90548-Q/fulltext

This paper is about the artery being damaged during a LEFORT 3 and mandible angle fracture. The patients didn't die but it looked to be a 'wait and see' process until the time they noticed neurologic deficit and extreme weakness (hemiparesis) of one side of body.

"Abstract
Two cases of internal carotid artery thrombosis associated with a maxillary Le Fort III and mandibular angle fractures after maxillofacial blunt injuries are described. Both patients had delayed neurologic deficit and hemiparesis. The diagnosis was made by carotid angiography after clinical evidence of thromboembolism. Clinical aspects and etiology, with special attention to mechanism of injury, are discussed."
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"Massive Hemorrhage During Oral and Maxillofacial Surgery: Ligation of the External Carotid Artery or Embolization?"

https://www.researchgate.net/publication/26296626_Massive_Hemorrhage_During_Oral_and_Maxillofacial_Surgery_Ligation_of_the_External_Carotid_Artery_or_Embolization

That's just the FIRST TITLE of the LINK given here. On the same link, there are a BOAT LOAD of articles/case studies about massive bleeding and artery damage during maxillo-facial surgery.

Some snippets from the series of articles. Some of which are about massive bleeding even after a tooth extraction!:

"....As far as we could determine, this triangular space has not been described before [22,25,28]. Even today, penetrating injuries to the head and neck region associated with significant arterial Posterior auricular artery, 12 Superficial temporal artery, 13 Internal carotid artery, 14 Common carotid artery, 15 Superior thyroid artery, 16 Lingual artery, 17 Hypoglossal nerve bleeding constitute surgical emergencies that are frequently very difficult to handle [2,3,5,29]. The literature suggests that about 25% of penetrating neck trauma cases are associated with vascular injuries, with the internal carotid being the most frequently affected artery [5,30]...."

"Stab injury to the preauricular region with laceration of the external carotid artery without involvement of the facial nerve: A case report."

"Life-threatening bleeding after tooth extraction due to vascular malformation: a case report and literature review."

"Massive bleeding after a tooth extraction: Diagnosis of unknown arteriovenous malformation of the mandible, a case report"

"A Critical Review of the Literature and an Evidence-Based Approach for Life-Threatening Hemorrhage in Maxillofacial Surgery"

The list goes on with MANY other articles.
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kavan

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Re: (LOTS of) Complications associated with orthognathic surgery
« Reply #25 on: July 12, 2019, 11:26:06 AM »
A few years ago when I first heard of Justin's I remember looking it up and IIRC someone said it was the carotid artery. Whichever one it was, the discussion online was it was severed and not noticed (how could it not be noticed?) Someone (a sibling I think) had posted proper updates on either youtube or the other jaw forum at some point.

Someone saying it was 'severed' doesn't really confirm whether it was. Could have been severed or could have been generic description of BLUNT INJURY to the artery. Of course, I have no way of knowing. Just to say it not being noticed during surgery is more in line with BLUNT injury to the artery.

Check out the list of articles I dug up on injuries to the carotid artery where it's the BLUNT injuries that cause the damage that can become a 'wait and see' process in the sense they might not be noticed immediately.

I WONDER if the OSHU wrote a case study on this. If not, they should have. However, I don't know what the issues are with doing so like whether or not the family needs to approve or not.

 
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Post bimax

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Re: (LOTS of) Complications associated with orthognathic surgery
« Reply #27 on: July 23, 2019, 09:25:11 AM »
Carotid artery on the left side of his brain was torn? According to the poster

GJ

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Re: (LOTS of) Complications associated with orthognathic surgery
« Reply #28 on: July 23, 2019, 09:30:35 AM »
Millimeters are miles on the face.

kavan

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Re: (LOTS of) Complications associated with orthognathic surgery
« Reply #29 on: July 23, 2019, 03:40:41 PM »
Good find April.  I managed to read that one page in the link of multi pages of many posts. But since I'm not a member of that blog, i could not read all of the posts.  Anyway, I'm copying and pasting the part about the doctor's name:


"Justin had his surgery at the Shriners' Hospital in Portland, Oregon. It was performed by Doctor Anna A. Kuang, the surgeon who is in charge of the Cleft Palate program at the Oregon Health & Science University, also in Portland. I now know that it was the carotid artery on the left side of his brain that was torn. Dr. Kuang was unable to see artery tear as the carotid is in the back of the head and out of her sight at the time of the surgery. So far, I've not heard anything from the autopsy but if I learn more I will send more info if you're interested or know someone who is.


Doctor Kuang has apologized many times and even came to see Justin prior to his passing. She hasn't had an easy time either having never had anything like this happen before. I still feel it was an accident. It's just going to take time to heal. I miss him."
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