Format

Send to

Choose Destination
See comment in PubMed Commons below
J Oral Maxillofac Surg. 1999 Jan;57(1):8-13; discussion 14-5.

Six year's experience with the zygomatic "sandwich" osteotomy for correction of malar deficiency.

Author information

  • 1Department of Surgery, General Hospital St John, Bruges, Belgium.

Abstract

PURPOSE:

This study discusses the rationale, modifications, and complications of an osteotomy technique used to increase malar projection.

PATIENTS AND METHODS:

Seventy "sandwich" zygomatic osteotomies were performed in a 6-year period. Hydroxyapatite (HA) blocks were used to stabilize the anterolateral rotation of the zygomatic body in 44 osteotomies, calcium carbonate blocks were used in 23, calvarial bone grafts in three, a piece of bovine cartilage in one, and a bone graft from a chin ostectomy procedure combined with mesh osteosynthesis in one procedure. Fifty-six zygomatic osteotomies were combined with Le Fort I-type osteotomies (eight with a midline split). Nineteen zygomatic osteotomies were performed simultaneously with a Le Fort I-type osteotomy and a rhinoplasty with lateral osteotomies.

RESULTS:

The increase of malar projection and the stability of the procedure could not be measured on conventional three-plane cephalograms. However, patient's and surgeon's satisfaction were high and remained so during the follow-up period (maximum, 6.5 years; minimum, 6 months). Three patients developed maxillary sinusitis. In two of them, this was clearly related to fragmentation of an HA block. A Treacher-Collins patient developed a chronic fistula in the upper vestibule, caused by leakage of infraorbitally placed HA granules. In two cases, a fracture of the zygomatic arch occurred. Osteosynthesis was performed in one of them.

CONCLUSION:

With proper technique and care not to fracture the interpositional HA block, complications are rare. The procedure is expedient and provides predictable and stable correction of malar deficiency.

PMID:
9915389
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Support Center