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Updated: Mar 10, 2026
Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
Published on: March 1, 2015
Midface Advancement in a Simple Approach
Herman Jr Vercruysse1, Ramon Sieira-Gil, Alfons Navarro
1*Department of Maxillofacial Surgery, Hospital Sant Joan de Déu, Universitat de Barcelona, Passeig de Sant Joan de Déu, Esplugues de Llobregat †Department of Plastic and Maxillofacial Surgery, Hospital Clinic ‡Human Anatomy Unit, School of Medicine, Universitat de Barcelona, Barcelona, Spain.
Background:
Midface advancement is a keystone intervention in the treatment plan of syndromic hypoplasia of the midface. Although earlier authors had been using a combination of smaller incisions to acquire enough access to perform the different osteotomies, Tessier popularized the bicoronal incision. This approach can be time-consuming however and leaves an ear-to-ear scar. The authors describe an endoscopically assisted piezo-electric Le Fort III osteotomy performed through minimal invasive access. The cutaneous incision was limited to a single-short mid-glabellar vertical scar (8 mm) to perform the nasofrontal and septum osteotomy. Further osteotomies are performed through a 1.5 cm intraoral incision and a transconjunctival approach with a retrocaruncular extension. A lateral canthotomy was avoided to lower the risk of postoperative eyelid malposition.
Methods:
A feasibility study using 2 fresh nonfrozen cadaver heads.
Conclusion:
The minimally invasive Le Fort III approach is feasible and efficacious for clinical use in a cadaveric setup.
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