Surgery in active acromegaly with prognathism and a lateral open bite

The case of a 33-year-old Caucasian with acromegaly is presented. The maxillo-facial deformity with the rare combination of unilateral open bite is demonstrated. The patient underwent surgical treatment of the pituitary gland three times. In the last operative procedure the sella was found to be empty, but despite this the growth hormone level appeared to be too high. Nevertheless, it was decided to correct the mandibular deformity. Risks during and after mandibular osteotomy are discussed, and the results are shown.