Seesaw modification of the lateral orbital wall in Le Fort III osteotomy

The traditional treatment for patients with syndromic craniosynostosis and midfacial retrusion has consisted of Le Fort III osteotomy and advancement. Distraction with rigid external systems allows advancement of the midface segment much more than the conventional methods. This excessive advancement resulted in the superiormost margin of the advancement segment becoming prominent. It can be felt easily with palpation and may influence the appearance of the patient negatively. This article presents a procedure osteotomy designed to modify the osteotomy lines at the lateral orbital rims and smooth the step deformity at the lateral canthal region.

The seesaw osteotomy produced a smooth contour at the lateral orbital rim. Planned advancement was achieved without difficulty and without adverse long-term effects.