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Contributors: Andrew Weaver and Kumar Patel, PA-C
18 y.o. female with Treacher-Collins syndrome (patients have micrognathia, underdeveloped facial bones, particularly the cheek bones, and a very small jaw and chin. She is only able to open her mouth to 20mm due to the interference of her coronoid process with her zygoma/
DOI: http://dx.doi.org/10.17797/959yiezvoo
Right Coronoidectomy & Sliding Osseous Genioplasty
: Coronoidectomy: increased jaw pain, limited incisal opening due to CT confirmed hyperplastic coronoid; Genioplasty: microgenia, asymmetric chin, chin recession
: extremely thin bone that cannot be plated, co-morbidities increasing surgical risk.
Supine, nasal intubation
history & physical, CBC, CMP, PT/INR 3D 1mm cut head/facial bone CT, standardized photographs
Coronoidectomy: intra-oral incision, watch for 'dimple' of Stensen's duct in the region of the 2nd molar; must identify the Sigmoid notch and start osteotomy at that level
Genioplasty: the course of the inferior alveolar nerve exiting the mental formamen usually ~ 5mm below this foramen between the 1 and 2nd pre-molars
Coronoidectomy: improved incisal opening, but without exercises post-operatively risk of contracture fibrosis
Genioplasty: improved facial balance harmony & aesthetics, mental nerve injury, step-off deformities
fibrosis of Temporalis muscle, Witches-chin deformity if the mentalis muscle is not re-suspended properly.
fibrosis of Temporalis muscle, Witches-chin deformity if the mentalis muscle is not re-suspended properly.
Jessica Boswell for helping to film
a. Soft Tissue Response After Chin Advancement Using Two Different Genioplasty Techniques." ResearchGate. N.p., n.d. Web. 24 Feb. 2016.
b. "One-Stage Treatment to Condylar Osteochondroma Combined With... : Journal of Craniofacial Surgery." LWW. N.p., n.d. Web. 21 Feb. 2016.
Review Sliding Osseous Genioplasty and Coronoidectomy in a Patient with Treacher-Collins Syndrome.