Rapid placement of a nasal spine wire for skeletal suspension

Abstract

The importance of skeletal suspension in orthognathic procedures of the mandible has been extensively documented.l-? Maxillomandibular fixation (MMF) alone can result in skeletal relapse with dental compensation, leading to functional and esthetic compromises. 1-7 Although rigid skeletal fixation has become increasingly popular, skeletal suspension in combination with MMF remains a useful technique, providing postsurgical stability essentially equal to that obtained using rigid fixation, and superior to MMF alone. 8 ,9 Skeletal suspension has even been advocated for the brief period of immobilization used in rigid techniques. 10 Furthermore, procedures such as the intraoral vertical and oblique subsigmoid osteotomies remain useful in selected cases, but do not lend themselves to rigid fixation. MMF with skeletal suspension may be used in these cases. Epker and Wessberg reported circummandibular wiring with infraorbital or piriform fossa suspension as a method of reducing skeletal relapse and dental compensations. 1 These maxillary suspension techniques require additional incisions, dissections, and closures. A simple and atraumatic method is described for rapid placement of an anterior nasal spine wire. This provides an effective means of achieving skeletal suspension and involves a minimum of surgical manipulation.