The U-Shaped Maxillary Osteotomy: A Novel Resource for the Treatment of the Middle Third Facial Hypoplasia.

Abstract

The purpose of orthognathic surgery procedures is to manipulate the elements of the facial skeleton to reestablish normal anatomy and function. These elements could be repositioned with the technique known as Le Fort I osteotomy. This technique can be modified to be adapted on each patient, depending on the anomaly presented and the planned objective. The versatility, offered by the modifications of the Le Fort I osteotomy, has taken us to design one that allows the capability to correct the malar region hypoplasia in the same surgical procedure. A total of 9 patients were included with malocclusion as indication for orthognathic surgery who also presented with malar hypoplasia diagnosed clinically and cephalometrically. A modified technique, the "U"-shaped maxillary osteotomy, was performed with excellent functional and aesthetics results, and none of the patients presented complications associated directly to the maxillary osteotomy. Some patients with maxillary zygomatic deficiency combined with malocclusion continue to present a special challenge to clinicians treating these deformities. This technique is useful in improving zygomatic projection in bloc with the Le Fort I advancement without the need to place a bone graft and the advantage of rigid fixation along with the one used in the Le Fort I osteotomy. The U-shaped maxillary osteotomy is a safe, trustworthy, and reproducible technique that allows the resolution of the maxillomalar hypoplasia in a single surgical time, providing satisfactory aesthetic results. Any surgeon with adequate training in orthognathic or craniofacial surgery could perform it and incorporate it to his technical armamentarium.