A modified approach to the Le Fort II osteotomy

A modified technique of Le Fort II osteotomy is described for the correction of naso-maxillary hypoplasia. The surgical access was via a combination of bicoronal flap and transoral sulcular incision. Any periorbital skin incision is avoided. This is made possible by having the medial orbital cut made through the lacrimal groove. The anterior limb of the medial canthal ligament is detached, but leaving the posterior and superior limbs intact. Following mobilization, the osteotomy segment is stabilized by miniplates without intermaxillary fixation. This method eliminates the need for facial incision and hence the residual scar. Patients' recovery and acceptability of this modified approach to Le Fort II osteotomy is much enhanced.