A Case of Orthognathic Surgery for Jaw Deformity in a Patient with Spinocerebellar Ataxia

Abstract

Summary:. Spinocerebellar ataxia (SCA) is a progressive neurodegenerative disease that can cause various ataxia symptoms. Here we report a patient with spinocerebellar ataxia who underwent orthognathic surgery to correct a mandibular protrusion with facial asymmetry. A 33-year-old woman was admitted to our hospital for orthognathic surgery. She started preoperative orthodontic treatment after a diagnosis of mandibular protrusion with facial asymmetry. Two and a half years later, after completing preoperative orthodontic treatment, she returned to our hospital after being diagnosed with spinocerebellar ataxia. After discussing the risk of surgery with the anesthesiologist and neurologist, we elected to perform orthognathic surgery after the patient provided informed consent. Sagittal split ramus osteotomy and intraoral vertical ramus osteotomy were performed under general anesthesia, but no remarkable perioperative complications occurred. After a 3-year follow-up, the occlusion has remained stable, and no postoperative relapse occurred. Whether we should provide surgical treatment for SCA patients is controversial. However, when long-term predictions were considered, altering an occlusion could improve a patient’s quality of life in the present case.