Outcome Monitoring Systems for Orthognathic Surgery Patients at University of Lagos Teaching Hospital: A Quality Improvement Evaluation

Orthognathic surgery, which involves the surgical correction of dentofacial skeletal discrepancies, requires robust pre- and postoperative monitoring to achieve optimal functional and aesthetic outcomes. In Nigerian teaching hospitals, systematic outcome monitoring frameworks for orthognathic procedures are rarely formalized. This quality improvement evaluation examines the current state of outcome monitoring practices for orthognathic surgery patients at the University of Lagos Teaching Hospital (LUTH), South West Nigeria, and proposes structured improvements to the existing pathway. A mixed-methods approach was used, including review of clinical records of 28 orthognathic cases managed between 2020 and 2024, interviews with four consultant oral and maxillofacial surgeons, and observation of pre-surgical orthodontic coordination meetings. Outcome parameters assessed include occlusal stability at six months, skeletal relapse rates, patient-reported quality-of-life scores, and satisfaction with facial aesthetics. Results reveal that fewer than 40% of reviewed patients had completed structured six-month follow-up assessments, and no formal patient-reported outcome measure (PROM) tool was routinely administered. Skeletal relapse was noted in 14.3% of cases, primarily in patients with incomplete orthodontic treatment completion before surgery. The evaluation recommends the adoption of a standardized orthognathic outcome proforma, the integration of validated PROMs such as the Orthognathic Quality of Life Questionnaire (OQLQ), and formal care pathway documentation at LUTH. Keywords: orthognathic surgery, outcome monitoring, quality improvement, LUTH, facial aesthetics.