Locoregional anesthesia for removal osteosynthesis hardware from healed corpus mandibularis fractures: A descriptive study of a series of 40 cases

INTRODUCTION: Locoregional anesthesia represents a very interesting modality for the removal of osteosynthesis hardware of the corpus mandibularis. Several procedures have been described, but each is dedicated to a single mandibular segment. MATERIAL AND METHODS: The surgical records of 40 patients treated with rigid internal fixation after maxillofacial traumas were reviewed. Study variables included age, sex, site and number of plates, time of plate removal, reasons for plate removal, and postoperative. RESULTS: Our study enrolled 40 patients, 45% of whom had single-focal plate placement and 55% of whom had bifocal plate placement. 66% of the patients with bifocal plate placement had the plates removed during the same operation. The average operative time was 45 min for bifocal and 28 min for single-focal approaches. Postoperative complications were observed only for the truncal analgesia procedure of the inferior alveolar nerve at the mandibular foramen. Anesthesia failure was reported in 2 patients. DISCUSSION: Various locoregional anesthetic procedures are used to remove mandibular body plates but each has its indication depending on the mandibular segment being treated. Factors that can lead to failure of locoregional anesthesia are dominated by the state of inflammation at the site and patient anxiety which can be minimized by premedication with anxiolytics. CONCLUSION: Locoregional anesthesia for removal of osteosynthesis hardware of the corpus mandibularis remains a good anesthetic method that is performed in good conditions when it is done in compliance with standards. Its use avoids the usual risks and complications that can occur under general anesthesia.