title: Simultaneous Le Fort I, II, and III osteotomies for correction of midface deficiency in Apert disease.
abstract: Le Fort III osteotomy was usually applied to correct midface hypoplasia in Apert syndrome, and various surgical modifications have been developed in recent years. In this article, we reported the simultaneous Le Fort I, II, and III osteotomies for segmental advancement of midface deficiency involving nasal bones, zygoma, inferior orbital rims, and maxilla in an adult Chinese patient with Apert syndrome. To achieve the ideal advancement of different parts of midface simultaneously, we divided the midface into 4 segments, including nasal bone combined with upper portion of maxilla, lower portion of maxilla, and left and right zygoma, with simultaneous Le Fort I, Le Fort II, and Le Fort III osteotomies, and each segment was repositioned as required respectively to obtain ideal facial aesthetics and favorable occlusion. The long-term stability of bony segment advancements also was observed during 7-year follow-up. Compared with segmental distraction osteogenesis or multiple-stage surgery, which mainly applied to younger patients with more severe midface hypoplasia, this single-stage strategy offered a reliable surgical alternative for treating adult patient with midface hypoplasia that should be corrected in different levels.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, People’s Republic of China.
authors.forename: Jiewen
authors.initials: J
authors.lastname: Dai
authors.forename: Xudong
authors.initials: X
authors.lastname: Wang
authors.forename: Hongbo
authors.initials: H
authors.lastname: Yu
authors.forename: Jie
authors.initials: J
authors.lastname: Cheng
authors.forename: Hao
authors.initials: H
authors.lastname: Yuan
authors.forename: Haijun
authors.initials: H
authors.lastname: Gui
authors.forename: Shunyao
authors.initials: S
authors.lastname: Shen
authors.forename: Guofang
authors.initials: G
authors.lastname: Shen
mesh_terms: D000168:Acrocephalosyndactylia / Q000000981:diagnostic imaging / Q000601:surgery*; D005147:Facial Bones / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D009971:Orthodontics, Corrective; D019340:Osteotomy, Le Fort / Q000379:methods*; D014057:Tomography, X-Ray Computed; D055815:Young Adult