21142 Reconstruction midface, LeFort I; 2 pieces, segment movement in any direction, without bone graft

Name of the Procedure:

Reconstruction Midface, LeFort I; 2 Pieces, Segment Movement in Any Direction, Without Bone Graft

Summary

This procedure involves reconstructive surgery on the midface, specifically modifying the upper jaw (maxilla). The surgeon cuts and moves two segments of the bone to achieve the desired alignment and function, without using a bone graft.

Purpose

The procedure is performed to correct deformities or structural issues in the midface area. It aims to improve facial symmetry, function, and aesthetics, as well as to address dental alignment and airway issues.

Indications

• Facial deformities due to trauma, congenital conditions, or developmental issues.
• Malocclusion or improper bite alignment affecting chewing and speaking.
• Obstructive sleep apnea linked to structural issues in the midface.
• Preparation for or recovery from orthognathic (jaw) surgery.

Preparation

• Fasting for several hours before the procedure, as instructed.
• Adjustment or temporary discontinuation of medications, especially blood thinners.
• Preoperative imaging, such as X-rays or CT scans, to study the facial anatomy.
• Comprehensive dental examination and possible adjustments by orthodontists.

Procedure Description

1. General anesthesia is administered for patient comfort.
2. The surgeon makes precise incisions to access the midface bones.
3. Using specialized surgical tools, the maxilla is cut into two segments.
4. The bone segments are carefully moved into the desired positions.
5. Internal fixation devices like plates and screws are used to secure the bone segments.
6. The incisions are closed with sutures, and the area is bandaged.

Duration

The procedure typically takes between 2 to 4 hours, depending on the complexity.

Setting

The procedure is performed in a hospital or a specialized surgical center.

Personnel

• A board-certified oral and maxillofacial surgeon.
• An anesthesiologist for administering and monitoring anesthesia.
• Surgical nurses and assistants.

Risks and Complications

• Infection at the surgical site.
• Bleeding or excessive swelling.
• Nerve damage leading to numbness or altered sensation.
• Nonunion or improper healing of the bone segments.
• Need for additional surgery if results are not satisfactory.

Benefits

• Improved facial symmetry and aesthetics.
• Enhanced function in terms of chewing, speaking, and breathing.
• Correction of malocclusion and better dental alignment.
• Potential resolution of sleep apnea symptoms.

Recovery

• Initial recovery involves a hospital stay of 1-2 days.
• Soft diet and restricted activity for several weeks.
• Pain management with prescribed medications.
• Follow-up appointments to monitor healing and progress.
• Full recovery can take several months, with gradual resumption of normal activities.

Alternatives

• Traditional orthognathic surgery involving bone grafts.
• Non-surgical options like orthodontic treatments for minor alignment issues.
• Continuous Positive Airway Pressure (CPAP) therapy for sleep apnea.

Patient Experience

The patient will be under general anesthesia during the procedure and will not feel pain. Post-surgery, there may be swelling, discomfort, and limitations in movement. Pain management will be provided, and the patient will be advised on measures to ensure comfort and aid in recovery.