Correction of retrusive chin in the reconstruction of face and neck burns using sliding genioplasty

Abstract

Maxillofacial skeletal deformities following burns of the face and neck are far more common in practice than the paucity of reported cases would indicate. Numerous articles have been devoted to surgical treatments of face and neck burns with skin graft or flap transfer. Only a scarce number of articles refer to the maxillofacial deformities caused by burns. Masson and Janvier studied 23 patients with extensive burn scar contracture of the neck following injury in childhood with dentomaxillofacial deformities continuing into adulthood. Their results showed retrusion of the chin profile in these patients [1], and correction of scar contracture of the neck as early as possible in patients whose mandible growth is still active was suggested. A case report of one child with a severe untreated neck burn demonstrated dental and skeletal deformities as a result of the pull of the burn scars [2]. The neck contracture was released and the resultant defect was resurfaced with a radial forearm free flap and skin grafts. The occlusal disturbance was remedied with bilateral mandible wedge osteotomies, 2 weeks after the soft tissue surgery of the neck. Another case report demonstrated severe anterior open bite in a 25-yearold woman who sustained chemical burns to the face and neck 5 years before [3]. The surgical program for the patient included release neck contracture, bilateral oblique osteotomy, subapical osteotomy of mandible and genioplasty with a silicon implant. From a clinical point of view, retrusion of the chin profile with obliteration of the cervicomental is common after skin graft or flap transfer for face and neck burns. To the best of our knowledge, the correction of the