title: Extraoral vertical subcondylar osteotomy with rigid fixation for correction of mandibular prognathism. Comparison with bilateral sagittal split osteotomy and surgical technique.
abstract: OBJECTIVE
  The aim was to compare outcome after extraoral vertical subcondylar osteotomy (EVSO) with rigid fixation and bilateral sagittal split osteotomy (BSSO) for correction of mandibular prognathism. The objectives were to examine treatment factors, postoperative results, and long-term stability. The surgical technique for EVSO is presented in detail.
  
  
  METHODS
  Lateral cephalograms and information from patient files of 65 consecutively operated patients with EVSO and 65 matching patients operated with BSSO were analyzed preoperatively, postoperatively, after 6 months and 3 years.
  
  
  RESULTS
  No clinically significant differences were observed in long-term stability. The retromandibular scar inferior to the earlobe after EVSO was on average 25 mm long and 1 mm wide, and was of no concern for most of the patients. Normal or near normal sensation to the lower lip/chin was reported by half of the BSSO patients at the 3-year follow-up.
  
  
  CONCLUSIONS
  Because no major differences in outcome were observed, EVSO with rigid fixation may be considered as a viable alternative if it is important to avoid alterations in sensation, whereas BSSO may be preferred if retromandibular scar is of concern.
authors.affiliation: Department of Maxillofacial Surgery, Oslo University Hospital (Head: Prof. P. Skjelbred), PO Box 4956, Nydalen, N-0424 Oslo, Norway. n.f.hagensli@odont.uio.no
authors.forename: Niels
authors.initials: N
authors.lastname: Hågensli
authors.forename: Arild
authors.initials: A
authors.lastname: Stenvik
authors.forename: Lisen
authors.initials: L
authors.lastname: Espeland
mesh_terms: D000328:Adult; D001860:Bone Plates; D001863:Bone Screws; D016022:Case-Control Studies; D002508:Cephalometry / Q000379:methods; D002680:Chin / Q000473:pathology; D002921:Cicatrix / Q000473:pathology; D004210:Dissection / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006987:Hypesthesia / Q000209:etiology; D008046:Lip / Q000473:pathology; D008137:Longitudinal Studies; D008297:Male; D008334:Mandible / Q000473:pathology; D063168:Mandibular Osteotomy / Q000295:instrumentation / Q000379:methods*; D061646:Operative Time; D056948:Orthognathic Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D009984:Orthopedic Fixation Devices; D059229:Osteotomy, Sagittal Split Ramus / Q000379:methods*; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011378:Prognathism / Q000601:surgery*; D012189:Retrospective Studies; D012684:Sensory Thresholds / Q000502:physiology; D014110:Touch / Q000502:physiology; D016896:Treatment Outcome; D055815:Young Adult