A NEWER, BETTER IDENTITY
Facial Rehabilitation in Facial Deformity
Patients with syndromes like Crouzon that lead to severe facial / cranial
deformities have to face a lot of psychological issues. Craniofacial
surgery is one such surgical measure that may come to their rescue. This
surgery that can transform the lives of patients from such Craniofacial
anomalies is available only in a few centres in India. Recently, BLK
completely transformed the life of a young girl using complex
Craniofacial surgery methods like LeFort III and LeFort I Osteotomy.
LeFort III (LF III) Osteotomy by virtue of its level and anatomical
outline allows the surgeon to modify significant facial landmarks. A
Crouzon Syndrome patient commonly reveals severe exorbitism or
bulging of eyes. The mid-face appears short vertically and severely
retruded, causing a severely concave profile.
Lefort III Osteotomy is a Craniofacial Disjunction procedure which
requires mobilization of whole of the midface. The Osteotomy starts at
the frontozygomatic (FZ) suture. The Osteotomy line is carried from the
FZ suture medially along the lateral wall, then to the floor and
continuing up to the medial orbital wall and the nasal bones. Zygomatic
arches are divided in the middle.
Craniofacial Disjunction is then performed just below the frontonasal
suture, keeping in mind the cranial base slope. Next, Pterygomaxillary
Disjunction is carried out and whole of the midface is mobilised.
Following completion of the LF III Osteotomy, LFI Osteotomy is carried
out. A surgical splint is then used to bring the dentition in the desired
occlusion. The planned advancement at the upper midface level is
accomplished. The bone graft is used to bridge the Osteotomy sites.
Orthodontic treatment is started at around 3 weeks post-surgery to
bring the teeth into proper bite or occlusion.