Maxillary and Mandibular Healing After Facial Allotransplantation

Area of Science:

• Oral and Maxillofacial Surgery
• Transplant Surgery
• Reconstructive Surgery

Background:

• Facial transplantation is a treatment for severe facial injuries.
• Maxillary and mandibular bone healing after transplantation is not well-documented.
• Le Fort III and bilateral sagittal split osteotomies (BSSO) have high healing rates in non-transplant patients.

Purpose of the Study:

• To compare maxillary and mandibular bone healing in facial allotransplantation patients.
• To assess the outcomes of Le Fort III and BSSO osteotomies in face transplant recipients.

Main Methods:

• Retrospective chart review of facial allotransplantation patients.
• Analysis of demographics, procedures, and bone healing using computed tomography (CT).
• Inclusion of three patients: two with Le Fort III and one with Le Fort III and BSSO.

Main Results:

• Le Fort III osteotomies showed mobility and fibrous union in all patients.
• Mandibular BSSO healed successfully with bony union confirmed by CT and histology.
• Clinically asymptomatic patients with midfacial fibrous union did not require revision.

Conclusions:

• Le Fort osteotomy healing is inferior in facial transplantation compared to non-transplant cases.
• Mandibular BSSO healing is successful, potentially due to its rich cancellous bone density.
• Facial transplant recipients experience different bone healing patterns based on osteotomy type.