Le Fort osteotomy

Overview

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Diagram of a Le Fort Osteotomy

A Le Fort osteotomy is a type of orthognathic surgery used to correct midface deformities. It involves surgical cutting and repositioning of the bones of the maxilla to improve function and aesthetics. The procedure is named after the French surgeon René Le Fort, who classified midfacial fractures into three distinct patterns, known as Le Fort fractures.

Types of Le Fort Osteotomies

Le Fort osteotomies are categorized into three main types, each corresponding to the level of the osteotomy:

Le Fort I Osteotomy

The Le Fort I osteotomy involves a horizontal cut above the teeth, allowing the surgeon to move the upper jaw (maxilla) in any direction. This procedure is commonly used to correct malocclusion, open bite, and maxillary hypoplasia.

Le Fort II Osteotomy

The Le Fort II osteotomy is performed at the level of the nasal bridge and the upper jaw. It is used to correct midface retrusion and other complex facial deformities. This type of osteotomy is less common than Le Fort I.

Le Fort III Osteotomy

The Le Fort III osteotomy involves the highest level of osteotomy, extending from the nasal bridge to the orbital rims. It is used to address severe midface deficiencies and is often part of craniofacial surgery for congenital conditions such as Crouzon syndrome and Apert syndrome.

Surgical Procedure

The surgical procedure for a Le Fort osteotomy typically involves the following steps:

1. Preoperative Planning: Detailed planning using 3D imaging and cephalometric analysis to determine the precise cuts and movements required.
2. Anesthesia: The patient is placed under general anesthesia.
3. Incisions: Intraoral incisions are made to access the maxilla, minimizing visible scarring.
4. Osteotomy: The surgeon performs the osteotomy at the predetermined level (I, II, or III).
5. Repositioning: The maxilla is repositioned according to the surgical plan.
6. Fixation: The bones are stabilized using titanium plates and screws.
7. Closure: The incisions are closed, and the patient is monitored during recovery.

Recovery and Complications

Recovery from a Le Fort osteotomy involves several weeks of healing. Patients may experience swelling, bruising, and discomfort. A soft diet is recommended initially. Potential complications include infection, bleeding, and nerve damage. Long-term follow-up is necessary to ensure proper healing and function.

Related Pages

• Orthognathic surgery
• Maxillofacial surgery
• Le Fort fractures
• Craniofacial surgery