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Bilateral Sagittal Spilt Osteotomy and Genioplasty in Patient with Lymphatic Malformation

Contributors: Michael Golinko, MD,  John Jones, MD, DMD,  Kumar Patel, PA

Bilateral sagittal split osteotomy and genioplasty in 5y/o girl with lymphatic malformation.

DOI#: https://doi.org/10.17797/hlo056ep2r

Bilateral Sagittal Spilt Osteotomy and Genioplasty
horizontal mandibular excess or asymmetry, need for mandibular advancement
co-morbidities increasing surgical risk
supine, nasal intubation, general anesthesia, Inferior alveolar nerve block
Dental impressions, 3D CT, photos, collected; precise cuts planned and post-operative appearance simulated; Post-op chin strap constructed. History & Physical Exam, CBC, Coagulation Profile, CMP, ASA Classification
With intra-oral incision, watch for 'dimple' of Stensen's duct in the region of the 2nd maxillary molar. Mucosa is incised at anterior border of the ramus, exposing the external oblique ridge, from the coronoid notch to the second molar. Reciprocating saw passed down the oblique ridge, approximately to the level of the 2nd molar, and then vertically down the inferior mandibular border. For genioplasty note course of the inferior alveolar nerve exiting the mental foramen usually ~ 5mm below this foramen between the 1st and 2nd pre-molars.
Correction of anterior open bite, better oral competence, positive aesthetic outcome. Operative risk and risk of post-op infection or regression.
bleeding following injury to the masseteric or inferior alveolar artery, unanticipated splits/fractures, witches-chin deformity from improper mentalis muscle suspension, damage to Inferior alveolar or mental nerve
bleeding following injury to the masseteric or inferior alveolar artery, unanticipated splits/fractures, witches-chin deformity from improper mentalis muscle suspension, damage to Inferior alveolar or mental nerve
N/A
Bilateral Sagittal Split Osteotomy, Laura A. Monson, MD. Semin Plast Surg. 2013 Aug; 27, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3805998/

Review Bilateral Sagittal Spilt Osteotomy and Genioplasty in Patient with Lymphatic Malformation.

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