J Surg Tech Proced | Volume 7, Issue 1 | Research Article | Open Access
Hector H1*, Rodney H1 , Alarcón N1 and Muñoz R1,2
1Department of Oral and Maxillofacial Surgery, University of Carabobo Maxillofacial Residency Program, Dr. Ángel Larralde University Hospital, Venezuela 2Department of Craniofacial Surgery, Palmer Children’s Hospital, Maryland, USA
*Correspondance to: Hector HerreraFulltext PDF
Purpose: 1. To establish the indications for advancement by Le Fort III osteotomy in patients with class III DFD due to true middle third deficiency and sequelae of cleft lip and palate. 2. To describe the technique of advancement by Le Fort III osteotomy in patients with class III DFD due to true middle third deficiency and sequelae of cleft lip and palate. 3. To analyze the functional and esthetic results of Le Fort III osteotomy advancement in patients with class III DFD due to true middle third deficiency and sequelae of cleft lip and palate. Materials and Methods: A retrospective study of cases diagnosed with class III DFD due to cleft lip and palate that underwent surgical correction at the Dr. Ángel Larralde University Hospital in Valencia, Carabobo, Venezuela from 2016 to the present year, without distinction of gender and age, was carried out. Describing the protocol currently used in our country for the correction of such deformity, evaluating aesthetic changes, and functional and psychosocial pre and postoperative results in each patient. For this research, the combination of the bibliographic theoretical references will be used in its theoretical context, as well as the data from the medical history and the necessary studies to achieve the definitive diagnosis. Conjugated with the necessary surgical phases for the orthognathic correction of patients with class III DFD due to true deficiency of the middle third and sequelae of cleft lip and palate with the advancement of a Le Fort III osteotomy. Population and Sample: Being a case study, the sample is represented by three individuals, which will have the specific characteristics required for the treatment to be performed, such as a patient with true middle third deficiency treated under the corrective and reconstructive protocol for patients with complete cleft lip and palate that is applied in our postgraduate program. The patient was asked for informed consent. Inclusion Criteria: 1) True middle-third deficiency due to cleft lip and palate. 2) Complete cleft lip and palate. 3) Chronology of treatment of cleft lip and palate patients, correctly and timely applied within our training program. 4) Preserved hypernasality. Exclusion Criteria: 1) Systemic pathology that contraindicates orthognathic reconstructive surgery. 2) Patients improperly managed under the cleft lip and palate treatment protocol. 3) High probability of increased velopharyngeal incompetence. Results: The exposition of each case of the unit of analysis developed in the research is presented. Conclusion: The objectives set out at the beginning of this research were achieved since the diagnostic elements that led to deciding the surgical management through LF III osteotomy for the correction of midface deficiency in patients with cleft lip and palate were described, based on the clinical and imaging evaluation, the interdisciplinary consultation and the general health status of the patient, complemented by the experience of the surgical team. Likewise, the surgical procedures used in the surgical resolution of the patients are discussed, detailing with the support of photographic images the steps executed during the surgical approach and the surgical procedures planned in them.
Monobloc; Osteogenic distraction; Le Fort III; Crouzon syndrome; Facial bipartition; Median fasciotomy
Hector H, Rodney H, Alarcón N, Muñoz R. Venezuelan Protocol for the Correction of Midface Deficiency by Le Fort III Osteotomy in Patients with Cleft Lip and Palate. J Surg Tech Proced. 2023;7(1):1060..