Bone and Soft Tissue Changes after Two-Jaw Surgery in Cleft Patients.
10.5999/aps.2015.42.4.419
- Author:
Yung Sang YUN
1
;
Ki Il UHM
;
Jee Nam KIM
;
Dong Hyeok SHIN
;
Hyun Gon CHOI
;
Soon Heum KIM
;
Cheol Keun KIM
;
Dong In JO
Author Information
1. Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea. 20110112@kuh.ac.kr
- Publication Type:Original Article
- Keywords:
LeFort osteotomy;
Sagittal split ramus osteotomy;
Cleft lip and palate;
Orthognathic surgery
- MeSH:
Cleft Lip;
Humans;
Lip;
Mandible;
Maxilla;
Orthognathic Surgery;
Osteotomy;
Osteotomy, Le Fort;
Osteotomy, Sagittal Split Ramus;
Palate
- From:Archives of Plastic Surgery
2015;42(4):419-423
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Orthognathic surgery is required in 25% to 35% of patients with a cleft lip and palate, for whom functional recovery and aesthetic improvement after surgery are important. The aim of this study was to examine maxillary and mandibular changes, along with concomitant soft tissue changes, in cleft patients who underwent LeFort I osteotomy and sagittal split ramus osteotomy (two-jaw surgery). METHODS: Twenty-eight cleft patients who underwent two-jaw surgery between August 2008 and November 2013 were included. Cephalometric analysis was conducted before and after surgery. Preoperative and postoperative measurements of the bone and soft tissue were compared. RESULTS: The mean horizontal advancement of the maxilla (point A) was 6.12 mm, while that of the mandible (point B) was -5.19 mm. The mean point A-nasion-point B angle was -4.1degrees before surgery, and increased to 2.5degrees after surgery. The mean nasolabial angle was 72.7degrees before surgery, and increased to 88.7degrees after surgery. The mean minimal distance between Rickett's E-line and the upper lip was 6.52 mm before surgery and 1.81 mm after surgery. The ratio of soft tissue change to bone change was 0.55 between point A and point A' and 0.93 between point B and point B'. CONCLUSIONS: Patients with cleft lip and palate who underwent two-jaw surgery showed optimal soft tissue changes. The position of the soft tissue (point A') was shifted by a distance equal to 55% of the change in the maxillary bone. Therefore, bone surgery without soft tissue correction can achieve good aesthetic results.
