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[High level Le Fort I osteotomy and bone grafting for correction of secondary mid-face deformities in cleft patients]
1Trauma Repair, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100041, P.R. China.
Objective:
To explore the feasibility of combining high level Le Fort I osteotomy with bone grafting in the same operation for correction of secondary mid-face deformities in cleft patients.
Methods:
From January 2002 to January 2005, 10 patients suffering from secondary mid-face deformities were treated. There were 4 males and 6 females, aged from 16 to 32 years. The unilateral cleft was involved in 8 patients and the bilateral cleft in 2 patients. All patients received combining high level Le Fort I osteotomy with bone grafting in the same operation. The horizontal corticotomy of high level Le Fort I osteotomy on anterior wall of maxillary bone is higher than that of traditional Le Fort I osteotomy, it is only 5 mm close to infraorbital foramen.
Results:
All 10 patients were satisfied with their appearances after operation. Dental articulation was improved greatly in 9 patients. With an X-ray re-examination, maxillary was returned to normal position in all patients. After a follow up from 6 months to 2 years, dental arch had good appearance. The X-ray films showed no obvious bone absorption. The density of grafting bone was approximation to the normal bone.
Conclusion:
High level Le Fort I osteotomy can make not only maxillary advance, but also regions of lateral and floor of nose and partial infraorbital region advance. Combining with bone grafting in the same operation can decrease the frequency of operation, save the treatment expense and obtain an ideal effect. So it is an effective method for correction of the secondary mid-face deformities in cleft patients.
