A modification to horizontal sliding osteotomy for correction of asymmetrical chin
Majid Rezaei, Bahar Bassiri Gharb, Antonio Rampazzo,
Cleveland Clinic Foundation
Presenter: Majid Rezaei
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. The majority of this work at all steps has been done by Majid Rezaei
Director Name: Bahar Bassiri Gharb
Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Introduction: Chin asymmetry is often a presentation of underlying maxillomandibular growth imbalance. In some patients, it is impossible to perform orthognatic surgery due to financial issues, improper previous orthodontic treatment or patient's denial. Most of genial osteotomies are designed to treat retrogenia and lateral displacement in the coronal plan is not easily achievable because the bony cuts in a standard horizontal sliding osteotomy extend beyond the mental nerves. We devised a modification to the standard technique to overcome this problem with a precisely controlled vertical and lateral displacement.
Method: Based on the required lateral movements to rectify the deviation from facial midline, a block of bone is removed on the side opposite to the deviation, anterior to the nerve. Additional horizontal wedge resection might be necessary to correct the vertical difference between the left and right chin protuberances (VD). Fourteen patients were treated with this modified technique. Chin deviation from facial midline, Anterior-posterior (AP) position form subnasale perpendicular and VD were recorded pre and post operatively and. The results were compared by paired t-Test.
Results: Mean pre and post-op results were 8.57±1.45 mm versus 0.28±.57 mm for midline deviation (p=0.0001), 4.1± 0.8 mm versus 0.39 ± 0.56 for VD (p=0.0001) and -3.6±3.02 mm versus -2.14 ±1.02 for AP position of the chin (p=0.080), respectively.
Conclusion: These findings suggest that although there is always some asymmetry remained, simplicity of the procedure and reasonable correction of the chin position make this procedure a viable alternative.
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