A case of orthognathic surgery for a patient with mandibuluar prognathism and histrionic personality disorder

Abstract

Histrionic personality disorder is characterized by shallow and labile affectivity, selfdramatization, theatricality, exaggerated expression of emotions, suggestibility, egocentricity, selfindulgence, lack of consideration for others, easily hurt feelings, and continuous seeking for appreciation, excitement and attention.
We have provided orthognathic surgery for a mandibular prognathic patient with histrionic personality disorder in cooperation with psychiatrists.
The 23-year-old woman had been disgusted by her misshapen face since the age of seven. An orthodontist referred her to our department for surgical treatment of mandible protrusion. The patient had already been under treatment for histrionic personality disorder at the psychiatry department of our hospital since the age of eighteen.
We first consulted with the psychiatrists, who assured us that she would be able to undergo the surgical procedure. We performed sagittal splitting ramus osteotomy and genioplasty.
The post-surgical course was good physically, but the mental problems included delirium. These were promptly resolved in cooperation with the psychiatrists.
She is now satisfied with the result of the treatment, including occlusion and appearance, and her mental condition is stable.
Not only the somatic but also the mental condition must be taken into consideration when conducting orthographic surgery for the patient with histrionic personality disorder.