Abstract
Orthognathic surgery is sometimes performed for fibrous dysplasia to correct malocclusion or facial asymmetry. However, Le Fort 1 osteotomy for this disease is difficult because of severe anatomical abnormality. Computerassisted surgery is a rapidly developing technique in oral and maxillofacial surgery that is helping to ensure the safety of the surgery. We report a case of polyostotic craniofacial fibrous dysplasia in which two-jaw orthognathic surgery was performed using a navigation system with the Le Fort 1 osteotomy procedure. A 29-year-old woman presented with swelling and asymmetry on the right side of her face. Craniofacial fibrous dysplasia on the right side had been previously diagnosed, and she had undergone conservative surgery several times before. The disease extended to the right mandible, maxilla, and zygomatic, temporal frontal, and orbital areas, including the skull base. We first performed conservative contouring around the frontal and orbital areas, and then Le Fort I osteotomy and sagittal split ramus osteotomy to correct the asymmetry and cant of the occlusal plane. A passive infrared navigation system (Vector Vision surgical navigation system) was used for the Le Fort I osteotomy. The postoperative course was stable, and the facial asymmetry and cant of the occlusal plane improved and remained suitable 2 years after surgery. Thus, Le Fort 1 osteotomy can be performed safely in fibrous dysplasia with the aid of a passive infrared navigation system.
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References
Chan Y-R, Noordhoff S. Treatment of craniomaxillofacial fibrous dysplasia: how early and how extensive? Plast Reconstr Surg 1989;86:835–842.
Valentini V, Cassoni A, Marianetti TM, Terenzi V, Fadda MT, Iannetti G. Craniofacial fibrous dysplasia: conservative treatment of radical surgery? A retrospective study on 68 patients. Plast Reconstr Surg 2009;123:653–660.
Yeow VKL, Chan Y-R. Orthognathic surgery in craniofacial fibrous dysplasia. J Craniofac Surg 1999;10:155–159.
Sachs SA, Kleiman M, Pasternak R. Surgical management of a facial deformity secondary to craniofacial fibrous dysplasia. J Oral Maxillofac Surg 1984;42:192–196.
Samman N, Piette E, Cheung LK, Tideman AH. Feasibility of osteotomies in fibrous dysplasia of the jaws. Int J Oral Maxillofac Surg 1991;20:353–356.
Cheung LK, Samman N, Pang H, Tiedman AH. Titanium miniplate fixation for osteotomies in facial fibrous dysplasia. A histological study of the screw/bone interface. Int J Oral Maxillofac Surg 1995;24:401–405.
Caversaccio M, Langlotz F, Nolte L-P, Hausler R. Impact of a selfdeveloped planning and self-constructed navigation system on skull base surgery: 10 years experience. Acta Otolaryngol 2007;127:403–407.
Widmann G, Stoffner R, Bale R. Errors and error management in image-guided craniofacial surgery. Oral Surg Oral Med Oral Pathol Oral Rad Endod 2009;107:701–715.
Cheung LK, Fung SC, Samman N. Posterior maxillary anatomy: implication for Le Fort 1 osteotomy. Int J Oral Maxillofac Surg 1998;27:346–351.
Heiland M, Habermann CR, Schmelzle. Indication and limitation of intraoperative navigation in maxillofacial surgery. J Oral Maxillofac Surg 2004;62:1059–1063.
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Matsuo, A., Kono, M., Toyoda, J. et al. Navigation surgery for Le Fort 1 osteotomy in a fibrous dysplasia patient. Odontology 98, 181–184 (2010). https://doi.org/10.1007/s10266-010-0124-5
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DOI: https://doi.org/10.1007/s10266-010-0124-5