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Long-term results on the quadrangular osteotomy.

J J Brouns1, H P Freihofer

  • 1Department of Oral and Maxillofacial Surgery, University of Nymegen, The Netherlands.

International Journal of Oral and Maxillofacial Surgery
|August 1, 1992
PubMed
Summary
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This study evaluated quadrangular osteotomy for hypoplastic maxilla, finding high patient satisfaction despite significant vertical relapse and complications like infra-orbital nerve sensory loss and fractures. Further research is needed for improved outcomes.

Area of Science:

  • Maxillofacial surgery
  • Orthognathic surgery
  • Craniofacial reconstruction

Background:

  • Hypoplastic maxilla with retruded infra-orbital rims presents a surgical challenge.
  • Quadrangular osteotomy is indicated for specific midface skeletal discrepancies.
  • Understanding long-term outcomes and complications is crucial for patient management.

Purpose of the Study:

  • To present follow-up results of quadrangular osteotomy in patients with hypoplastic maxilla.
  • To assess patient satisfaction, skeletal relapse, and surgical complications.
  • To evaluate the efficacy and safety of this surgical technique.

Main Methods:

  • Follow-up study of 17 patients who underwent quadrangular osteotomy.
  • Evaluation of horizontal and vertical skeletal relapse.

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  • Assessment of patient-reported satisfaction and surgical complications.

    • Main Results:

    • High patient satisfaction reported by almost all patients.
    • Significant vertical relapse (61.7%-158%) observed, with minimal horizontal relapse (approx. 12%).
    • High rates of intraoperative fractures of the infra-orbital wing and sensory loss (79%) noted. Four patients required corrective surgery for complications, including ischemic necrosis.

    Conclusions:

    • Quadrangular osteotomy can achieve high patient satisfaction for selected cases of hypoplastic maxilla.
    • Significant vertical instability and a high complication rate, including nerve damage and fractures, are major concerns.
    • Further refinement of surgical techniques is necessary to mitigate relapse and complications.