jawsurgeryforums.com
General Category => Functional Surgery Questions => Topic started by: bpanther on October 12, 2014, 05:41:20 AM
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As we all know, Earl got a modified lefort III done to improve his midface projection. How do you guys reckon that compares to seemingly easier, less invasive procedures like a zygomatic osteotomy combined with orbital rim augmentation (most likely with implants or HA)? If you were to hypothetically have this done, which out of the two would you choose?
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As we all know, Earl got a modified lefort III done to improve his midface projection. How do you guys reckon that compares to seemingly easier, less invasive procedures like a zygomatic osteotomy combined with orbital rim augmentation (most likely with implants or HA)? If you were to hypothetically have this done, which out of the two would you choose?
Have you contacted earl? I'm sure his thoughts will be more helpful than anyone's here, since he's read so much on the subject.
Here are some random thoughts of mine (completely random):
Le Fort iii would move the whole segment forward, isn't that right? Zygomatic osteotomy is more of a lateral movement, some variations of it provide for modest anterior projection.
HA augmentation to the orbital rim would be very modest. Depending on the nature and magnitude of your problem, this may or may not be enough.
Moving the whole segment as one unit would be aesthetically superior, as one study showed (I read it a few weeks ago, but can't look for it now). Treating the three areas separately opens the door for imbalances and asymmetries.
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I may be mistaken, but I don't think earl25 had an actual Le Fort III. As far as I can tell, it was some kind of zygomatic osteotomy and this is supported by what Andrew Heggie (Australian surgeon who has a lot of experience with Le Fort IIIs) has said about the zygomatic osteotomy having replaced the Le Fort III when it comes to non-syndrome patients.
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I may be mistaken, but I don't think earl25 had an actual Le Fort III. As far as I can tell, it was some kind of zygomatic osteotomy and this is supported by what Andrew Heggie (Australian surgeon who has a lot of experience with Le Fort IIIs) has said about the zygomatic osteotomy having replaced the Le Fort III when it comes to non-syndrome patients.
Elsewhere he has said that he specifically turned down a zygomatic osteotomy.
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Earl had a 'modified' Lefort III, not sure what the difference is though.
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I may be mistaken, but I don't think earl25 had an actual Le Fort III. As far as I can tell, it was some kind of zygomatic osteotomy and this is supported by what Andrew Heggie (Australian surgeon who has a lot of experience with Le Fort IIIs) has said about the zygomatic osteotomy having replaced the Le Fort III when it comes to non-syndrome patients.
Nope - He did have an actual Lefort III, albeit a modified one. His midface (zygoma, cheekbones) was advanced and the maxilla stayed in place. In a conventional Lefort III, the entire thing gets advanced as a single entity.
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That's kinda the point I was trying to make. They called it a "modifed Le Fort III" but at what point does it stop being a Le Fort III and just become a modified zygomatic osteotomy of some sort?
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That's kinda the point I was trying to make. They called it a "modifed Le Fort III" but at what point does it stop being a Le Fort III and just become a modified zygomatic osteotomy of some sort?
I don't think zygomatic osteotomies involve manipulating the orbital rim. It stops being a Lefort III when it's just the zygomatic bone that's moved, I guess. I'm not too sure.
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zygomatic osteotomy is not only limited just to the zygomatic bone, sometimes small part of maxillary bone (upper) is involved ..and then infraorbital foramen issue appear which is placed very closed to the orbital rim...or perhaps even it belongs to that part. ION damage possible (very important sensuary nerve) But it is rather in cases such like mine.... after fracture :) typical cheek trauma cause maxillary and zygomatic fracture