Key Points
-
Corticosteroids are used widely in maxillofacial surgery.
-
Psychosis may result from brief corticosteroid regimens.
-
Consultant surgeons may exercise holding power to keep 'at risk' patients in hospital.
-
Input from a consultant psychiatrist is vital to ensure a satisfactory outcome.
Abstract
Psychosis is an uncommon but well-recognised complication of short-term corticosteroid administration. We report a case of steroid-induced psychosis subsequent to a bimaxillary osteotomy.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Rome HP, Braceland FJ . The psychological response to ACTH cortisone, hydrocortisone, and related steroid substances. Am J Psychiatry 1952; 108: 641–651.
Rome HP, Braceland FJ . Use of cortisone, and ACTH in certain diseases: psychiatric aspects. Proc Staff Meet Mayo Clinic 1950; 25: 495–497.
Sisk A, Bonnington FJ . Evaluation of methylprednisolone and flurbiprofen for inhibition of the postoperative inflammatory response. Oral Surg 1985; 60: 137–145.
Galen DM, Beck M, Buchbinder D . Steroid psychosis after orthognathic surgery: a case report. J Oral Maxillofac Surg 1997; 55: 294–297.
Flood TR, McManners J, El Attar A, Moos KF . Randomized prospective study of the influence of steroids on postoperative eye-opening after exploration of the orbital floor. J Oral Maxillofac Surg 1999; 37: 316–319.
Bertolami CN, Cohen CH, Chrzanowsk RR . Quantitation of post-surgical oedema. J Oral Maxillofac Surg 1982; 40: 473–476.
Gersama L, Baker K . Use of corticosteroids in oral surgery. J Oral Maxillofac Surg 1992; 50: 270–277.
Munro IR, Boyd JB, Wainright DJ . Effects of steroids in maxillofacial surgery. Ann Plast Surg 1986; 17: 440–444.
Schaberg SJ, Stuller CB, Edwards SM . Effects of methylprednisolone on swelling after orthognathic surgery. J Oral Maxillofac Surg 1984; 42: 356–361.
Ferris RL, Eisele DW . Steroid psychosis after head and neck surgery: Case report and review of the literature. Otolaryngol Head Neck Surg 2003; 129: 591–592.
Guernsey LH, DeChamplain RW . Sequelae and complications of the intraoral sagittal split osteotomy in the mandibular rami. Oral Surg 1971; 32: 176–192.
Sirios F . Steroid psychosis: a review. General Hospital Psychiatry 2003; 25: 27–33.
Precious D, Hoffman CD, Miller R . Steroid acne after orthognathic surgery. Oral Med Oral Surg Oral Pathol 1992; 74: 279–281.
Butler RCD, Vorono AA, Finstuen K . Dosage effects of pulsed steroid therapy on serum cortisol levels in oral and maxillofacial surgery patients. J Oral Maxillofac Surg 1993; 51: 750–753.
D'Orban PT . Steroid-induced psychosis. Lancet 1989; 2: 694.
Silva RG, Tolstunov L . Steroid-induced psychosis: Report of case. J Oral Maxillofac Surg 1995; 53: 183–186.
Young AH, Sahakian BJ, Robbins TW, Cowen PJ . The effects of chronic administration of hydrocortisone on cognitive function in normal male volunteers. Psychopharmacology (Berl) 1999; 145: 260–266.
Wolkowitz OM, Reus VI, Weingartner H et al. Cognitive effects of corticosteroids. Am J Psychiatry 1990; 147: 1297–1303.
Harrison JA, Nixon MA, Fright WR, Snape L . Use of hand-held laser scanning in the assessment of facial swelling: a preliminary study. Br J Oral Maxillofac Surg 2004; 42: 8–17.
Author information
Authors and Affiliations
Corresponding author
Additional information
Refereed Paper
Rights and permissions
About this article
Cite this article
Fleming, P., Flood, T. Steroid-induced psychosis complicating orthognathic surgery: A case report. Br Dent J 199, 647–648 (2005). https://doi.org/10.1038/sj.bdj.4812929
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/sj.bdj.4812929
This article is cited by
-
The influence of dexamethasone on postoperative swelling and neurosensory disturbances after orthognathic surgery: a randomized controlled clinical trial
Head & Face Medicine (2017)
-
“I was never like that”: Australian findings on the psychological and psychiatric sequelae of corticosteroids in haematology treatments
Supportive Care in Cancer (2009)
-
Hallucinations and tremors due to oral therapeutic doses of erythromycin and methylprednisolone
Internal and Emergency Medicine (2008)
-
Visual hallucinations on eye closure after orthopedic surgery under general anesthesia
Journal of Anesthesia (2008)