45 Years of Simultaneous Le Fort III and Le Fort I Osteotomies: A Systematic Literature Review. (July 2015)

• Record Type: Journal Article
• Authors: Brown, Matthew S.; Okada, Haruko; Valiathan, Manish; Lakin, Gregory E.
• Is Part Of: Cleft palate-craniofacial journal. Volume 52:Number 4(2015)
• Page Start: 471
• Page End: 479
• Publication Date: 2015-07
• Subjects: Le Fort I -- Le Fort III -- simultaneous; Cleft palate -- Periodicals; Skull -- Abnormalities -- Periodicals; Cranial manipulation -- Periodicals; Skull -- Abnormalities -- Surgery -- Periodicals; Face -- Abnormalities -- Surgery -- Periodicals; Fente palatine -- Périodiques; Crâne -- Malformations -- Périodiques; Manipulation crânienne -- Périodiques; Crâne -- Malformations -- Chirurgie -- Périodiques; Face -- Malformations -- Chirurgie -- Périodiques; Cleft palate; Cranial manipulation; Face -- Abnormalities -- Surgery; Skull -- Abnormalities; Skull -- Abnormalities -- Surgery; Cleft Lip; Cleft Palate; Facial Bones -- abnormalities; Skull -- abnormalities; Periodicals; Periodicals; Periodicals; 617.522
• DOI: 10.1597/14-005R
• Languages: English
• ISSNs: 1055-6656

Abstract

Objective: To review and collectively summarize our knowledge of simultaneous Le Fort III and Le Fort I osteotomies. Design: A PubMed search using "Le Fort III, " "simultaneous Le Fort III and Le Fort I, " "combined Le Fort III and Le Fort I, " "dual midface, " and "segmental midface" was performed. Articles with relevant abstracts were obtained for formal review. A new case of simultaneous Le Fort III and Le Fort I is presented to describe and discuss specific operative indications and surgical decisions. Results: There were 14 articles that met inclusion criteria with reports of simultaneous Le Fort III and Le Fort I osteotomies. A total of 20 cases were present in the literature. No major complications were reported. We performed combined Le Fort III with Le Fort I osteotomies in a 25-year-old patient with Crouzon syndrome who had undergone a previous Le Fort III at the age of 4 years. The patient tolerated the procedure well, and postoperatively, her exophthalmos and class III malocclusion were corrected. Conclusions: Simultaneous Le Fort III and Le Fort I can correct differential upper and lower midface hypoplasia and is a well-tolerated procedure in the mature facial skeleton. This systematic review improves our understanding of the surgical technique and indications for a procedure that can correct complex midfacial deformities.