Modified Le Fort III osteotomy: A simple solution to severe midfacial hypoplasia

Fariña, R; Valladares, S.; Raposo, Araceli; Silva, Francisco

doi:10.1016/j.jcms.2018.03.010

Cited by 12 publications

(11 citation statements)

References 25 publications

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“…Literature review found that there were only 2 studies 7,10 reports on the efficacy of surgical reconstruction for Le Fort III fractures in the past, but they did not use quantitative indicators to evaluate the efficacy of surgical reconstruction for Le Fort III fractures. In many studies [11][12][13][14] on Le Fort III osteotomy for craniofacial decompression deformities, orbital volume was used as a quantitative index to evaluate the effect of surgery. Therefore, in this study, orbital volume was also used as a quantitative index to evaluate the efficacy of surgical reconstruction for Le Fort III fractures.…”

Section: Discussionmentioning

confidence: 99%

Orbital Reconstruction in Le Fort III Fractures

Wang

Chen

et al. 2022

Journal of Craniofacial Surgery

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Background: Few quantitative results are reported about the surgical effect of orbital reconstruction in Le Fort III fractures. The authors' team proposed an ordered surgery method which was effective for Le Fort III fractures. The aim of this study was to evaluate the effectiveness of this method with quantitative outcomes. Methods: A retrospective study was conducted of all patients who were diagnosed with Le Fort III fractures and underwent orbital and facial fractures repair from January 2015 to June 2019. Surgical reconstruction was performed with an ordered surgery method. Orbital volumes were used to evaluate the effectiveness of orbital reconstruction. Results: Fifteen patients (21 eyes) with Le Fort III fractures were included in this study. Preoperative and postoperative orbital volume changes were statistically significant (P < 0.01). For unilateral fractures, orbital volumes were different in 2 eyes (P < 0.01). For bilateral fractures, orbital volumes were almost the same in 2 eyes (P = 0.34). For the affected eye in unilateral fractures group and eyes in bilateral fractures group, after surgery, orbital volume were almost the same (P = 0.35). Conclusions: This study showed effectiveness and safety of the ordered surgery in the treatment of Le Fort III fractures, which would result in significant decrease in orbital volumes.

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Section: Discussionmentioning

confidence: 99%

Orbital Reconstruction in Le Fort III Fractures

Wang

Chen

et al. 2022

Journal of Craniofacial Surgery

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“…This technique was used for the TDO with a modified Le Fort III osteotomy, where the osteotomy was performed using low morbidity approaches (transconjunctival and transoral approaches), a shorter surgery time and low blood loss, in contrast to conventional Le Fort III techniques. This technique avoids the use of grafts and osteosynthesis material 4 . On the other hand, by not including the nasal pyramid, the size, position and nasofrontal angle are maintained, with the possibility of a deferred rhinoplasty in the event that an adequate facial balance is not achieved.…”

Section: Discussionmentioning

confidence: 99%

Cleft Lip and Palate Midfacial Hypoplasia: Criteria to Choose the Treatment

Fariña

Lolas

Moreno

et al. 2021

Journal of Craniofacial Surgery

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A series of skeletal and dentoalveolar/occlusal criteria were proposed for choosing the treatment modality for the management of midface hypoplasia in cleft lip/palate patients, focusing on functional improvement, aesthetics, and minimizing the risk of recurrence and secondary alterations. For which, 42 patients with nonsyndromic cleft lip/palate, all with previous primary lip/palate surgeries and without previous osteotomies, were analyzed. Orthognathic surgery (OS) (n ¼ 24) and maxillary distraction osteogenesis (n ¼ 18) with anterior segmental osteotomies (segmental distraction osteogenesis [SD]), alveolar transport disc (TD), and midface total distraction osteogenesis (TDO) by modified Le Fort III osteotomy was done.The average of maxillary advancement for OS was 5.58 AE 0.83 mm, for SD 9.4 AE 0.89 mm, for TD 8.00 AE 1.00 mm, and for TDO was 8.13 AE 1.55 mm.In the presence of infraorbital and/or zygomatic hypoplasia, TDO was performed using skeletal anchorage, with the requirement of occlusal stability in dental cast in occlusion. In short maxillary arch without dental cast feasibility in occlusion, hypodontia/agenesis or absence of premaxilla, TD and SD was performed. There was only 1 mm of recurrence in 1 patient of each group. Changes in speech were detected in 2 patients in the OS group (8.3%). Orthognathic surgery can be indicated for advancements 7 mm not requiring orbito-zygomatic advancement, whereas distraction osteogenesis can be indicated for advances >8 mm with or without the need for orbito-zygomatic advancement, in addition with other dentoalveolar factors and velopharyngeal function.

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“…En nuestro paciente se obtuvo un resultado muy aceptable tanto estético como funcional, sin la necesidad de combinar las osteotomías ni colocar injertos óseos. La osteotomía Le Fort III modificada evita la necesidad de injertos óseos, permitiendo mayor contacto óseo, no tiene cambios en estructuras óseas nasales, permite avanzar el borde orbitario inferior, las prominencias malares y el tercio medio, disminuye la exposición de la esclera, puede lar, la mandíbula y el mentón; no siempre se puede llegar a este objetivo con la osteotomía Le Fort I convencional 7,11 . La osteotomía Le Fort III modificada utilizada en un principio en pacientes con algún síndrome craneofacial, ofrece grandes ventajas en el tratamiento de corregir discretas discrepancias verticales (< 4 mm), dependiendo de la angulación en la osteotomía a nivel cigomático 8,[16][17][18] .…”

Section: Discussionunclassified

“…Obwegeser en 1969 describió una osteotomía Le Fort III y Le Fort I simultánea 4 ; Cheung describió la aplicación de una osteotomía Le Fort III oblicua modificada que incluía los huesos de la nariz además de una osteotomía Le Fort I con segmentación para el tratamiento de pacientes no sindró-micos con hipoplasia maxilar 5 . La osteotomía Le Fort III modificada ofrece grandes ventajas en el tratamiento de las deficiencias severas anteroposteriores maxilares en pacientes no sindrómicos [6][7][8][9] . La técnica que desarrollamos fue diseñada por García y Sánchez y cols.…”

Section: Introductionunclassified