Summary
Purpose
Despite maxillo-malar osteotomies having been discarded in the most recent literature,
in the setting of orthognathic surgery they provide several advantages for middle
third augmentation. This paper reintroduces maxillo-malar osteotomies as an effective
method to increase volume of midfacial region in combination with contemporary technology,
including piezosurgery, virtual surgical planning, and navigation.
Material and Methods
Eighteen patients with midface hypoplasia were included in this study and underwent
orthognathic surgery with maxillo-malar osteotomies. All patients underwent the same
workflow: virtual design of maxillo-malar osteotomies, surgery with navigation-assisted
piezoelectric osteotomies, and computerized morphometric analysis.
Results
Simulated maxillo-malar osteotomies were successfully replicated in the operating
room, as shown by accuracy evaluation performed using three-dimensional analysis.
In long-term follow-up period, no permanent complications were assessed. Superimposition
between postoperative and preoperative CBCTs revealed that the soft tissue area influenced
by the underlying skeletal movement was comparable for all cases.
Conclusions
Virtual surgical planning, navigation, and piezosurgery are today indispensable tools
to perform maxillo-malar osteotomies safely and accurately. We suggest incorporating
such osteotomies in the surgeon's armamentarium for patients with severe midfacial
hypoplasia as they offer an integrated solution to restore functionality and aesthetics.
Keywords
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Valls-Ontañón A. Malar augmentation with pedicled buccal fat pad in orthognathic surgery: three-dimensional evaluation [Internet]. 2016 Sep [cited 2020 Apr 11]. Available from: https://www.morressier.com/article/578e3b49d462b80292381721
Article info
Publication history
Published online: October 19, 2022
Accepted:
October 11,
2022
Received:
April 14,
2021
Identification
Copyright
© 2022 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
