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Orthognathic Surgery in Cleidocranial Dysplasia
Navid Pourtaheri1, Omar Allam2, Ludmila Chandler2
1Division of Plastic and Reconstructive Surgery, Riley Hospital for Children, Indiana University, Indianapolis, IN.
This study presents a successful surgical correction for cleidocranial dysplasia (CCD) using virtual surgical planning and advanced techniques. The case demonstrates stable and improved facial aesthetics and function after extensive orthognathic surgery.
Area of Science:
- Craniofacial Surgery
- Orthognathic Surgery
- Plastic Surgery
Background:
- Cleidocranial dysplasia (CCD) presents complex craniofacial abnormalities, with optimal surgical correction strategies yet to be universally established due to its rarity.
- This case report addresses the surgical management of significant craniofacial manifestations in a 27-year-old female patient diagnosed with CCD.
Observation:
- The patient underwent a comprehensive surgical procedure including virtual surgical planning (VSP), LeFort-I disimpaction, bone grafting, bilateral sagittal-split osteotomy, genioplasty, submental lipectomy, and facial fat grafting.
- A substantial 15-mm vertical maxillary disimpaction was performed, stabilized with wide maxillary plates and allogenic fibula grafts to ensure stability.
- Concurrent fat redistribution was employed to enhance facial aesthetics alongside skeletal reconstruction.
Findings:
- Postoperative assessment at six months revealed significant improvements in both the patient's appearance and functional symptoms.
- Computed tomography (CT) scans confirmed normalized skeletal relationships, with minimal changes between immediate and 6-month postoperative imaging indicating a stable surgical outcome.
- The extensive single-stage maxillary expansion was successfully managed, demonstrating the efficacy of the chosen surgical techniques.
Implications:
- This case highlights the potential of virtual surgical planning, robust fixation with wide maxillary plates, and interpositional bone grafts in optimizing outcomes for extensive maxillary expansion in CCD patients.
- The findings suggest that a multi-faceted surgical approach, including orthognathic surgery and aesthetic fat redistribution, can effectively address the complex craniofacial challenges posed by cleidocranial dysplasia.
- This approach provides a potential model for managing extreme skeletal discrepancies and achieving dentofacial harmony and improved aesthetics in rare craniofacial conditions.
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