Le Fort II Distraction with Simultaneous Zygomatic Repositioning

Area of Science:

• Craniofacial Surgery
• Orthognathic Surgery
• Pediatric Plastic Surgery

Background:

• Severe midface hypoplasia presents challenges in correcting abnormal facial proportions.
• Le Fort III distraction is a common surgical approach for midface hypoplasia.
• Apert facial dysmorphology often involves complex midface deficiencies.

Purpose of the Study:

• To present a modified Le Fort III distraction technique, termed Le Fort II distraction with zygomatic repositioning.
• To address specific patterns of midface deficiency where central hypoplasia is greater than lateral hypoplasia.
• To establish this modified procedure as a preferred surgical option for Apert facial dysmorphology.

Main Methods:

• The procedure involves initial Le Fort III osteotomies.
• Bilateral zygomas are subsequently separated and fixated.
• A central nasomaxillary Le Fort II segment is distracted for independent midface segment movement.

Main Results:

• This technique allows for differential distraction of central and lateral midface segments.
• It effectively corrects disproportionate midface deficiencies.
• The procedure has been adopted as the preferred method for Apert facial dysmorphology.

Conclusions:

• Le Fort II distraction with zygomatic repositioning offers a refined approach to managing severe midface hypoplasia.
• This modification provides enhanced control over central and lateral midface advancement.
• It is a highly effective treatment for patients with Apert facial dysmorphology and similar complex craniofacial conditions.