An extended Le Fort I osteotomy for correction of midface hypoplasia: a modified technique and results in 35 patients.

PURPOSE This report analyzes the long-term results of a transoral high Le Fort I osteotomy (mean observation period, 37 months). PATIENTS AND METHODS Thirty-five patients were treated with high Le Fort I osteotomies in which the zygomatic prominence was included in the osteotomy and advanced together with the maxilla. Twenty of the 35 patients were seen for long-term follow-up (mean, 37 months), which included clinical and radiographic examinations and anamnestic evaluation of the results. In nine patients it was possible to evaluate stability of the osteotomy by cephalometry. RESULTS The treatment results clinically appeared stable, with good occlusion and, in most patients, improved function of the masticatory system. Patients reported satisfactory esthetic results. Radiologically the SNA angle was unaltered in six of seven non-CLP (cleft lip and palate) patients and was decreased in two of two CLP patients. There were few complications; one patient had the maxilla reoperated because of a lack of osseous healing and one patient had pulp necrosis of three maxillary teeth. CONCLUSION The results achieved with the described method indicate that the use of minor modifications of routine surgical procedures in conventional orthognathic surgery can improve esthetic results in patients with extended midfacial hypoplasia.