Stellate Ganglion Block for Two Cases of Facial Nerve Palsy after Sagittal Splitting Ramus Osteotomy

Abstract

Facial nerve palsy following sagittal splitting ramus osteotomy (SSRO) is a rare but serious complication. Two cases of peripheral facial nerve palsy several days after orthognathic surgery, treated successfully with stellate ganglion blocks (SGB), were described. Case 1: A 17-year-old female underwent bilateral SSRO. Six days after the operation, right facial palsy was appeared. To improve the palsy, SGBs were performed, and the palsy was completely remitted. Case 2: A 19-year-old female underwent SSRO. Left facial palsy appeared on the eighth postoperative day. Palsy was almost remitted by 32 SGBs eight months after the operation. In the present cases, facial palsy might have arisen due to ischemic change of the nerve, which was caused by hematoma, edema, swelling, and tissue traction. SGB has been found to be effective in the treatment of facial palsy after SSRO