21206 Osteotomy, maxilla, segmental (eg, Wassmund or Schuchard)

Name of the Procedure:

Osteotomy, Maxilla, Segmental (e.g., Wassmund or Schuchard)

Summary

In layman's terms, this procedure involves surgical cutting and repositioning of the upper jaw (maxilla) to correct abnormalities and improve function or appearance. It is typically done in segments rather than as a whole piece.

Purpose

The purpose of a maxillary segmental osteotomy is to correct various dental and facial deformities. This can include issues like misalignment of the jaws, bite discrepancies, or other deformities that affect chewing, speaking, and appearance. The goals of the procedure are to enhance facial aesthetics, improve bite function, and alleviate related symptoms.

Indications

• Significant malocclusion (misaligned bite) that cannot be corrected with orthodontics alone.
• Facial asymmetries that cause functional or aesthetic issues.
• Congenital deformities such as cleft palate.
• Trauma or injury to the maxilla.
• Persistent jaw pain or discomfort.

Preparation

• Patients may need to fast for at least 6-8 hours before the procedure.
• Discontinue certain medications as advised by the surgeon (e.g., blood thinners).
• Preoperative imaging studies such as X-rays or CT scans are often required to plan the surgery.

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made inside the mouth to access the maxilla.
3. Precision instruments are used to carefully cut the maxilla into segments following the Wassmund or Schuchard technique.
4. The segments are repositioned as planned to correct the deformity.
5. The bones are secured using plates, screws, or other fixation devices.
6. The incision is closed, and the surgical site is cleaned.

Duration

The procedure typically takes between 1 to 3 hours, depending on the complexity of the case.

Setting

The surgery is usually performed in a hospital or a specialized surgical center equipped with the necessary facilities for maxillofacial surgery.

Personnel

• Oral and maxillofacial surgeon or facial plastic surgeon
• Anesthesiologist
• Surgical nurses
• Operating room technicians

Risks and Complications

• Infection at the surgical site
• Bleeding and swelling
• Nerve injury leading to numbness or tingling
• Difficulty with jaw movement
• Relapse or incomplete correction of the deformity
• Need for additional surgery

Benefits

• Improved jaw function and bite alignment
• Enhanced facial symmetry and aesthetics
• Relief from jaw pain and related symptoms
• Better overall oral health

Recovery

• Initial recovery often requires a hospital stay of 1-2 days.
• Pain, swelling, and discomfort are common and managed with medications.
• A soft or liquid diet may be necessary for several weeks.
• Follow-up appointments are crucial to monitor healing.
• Full recovery can take anywhere from 6 weeks to several months, depending on the individual.

Alternatives

• Orthodontic treatment alone, though it may not be sufficient for severe cases.
• Non-surgical facial orthotropics or myofunctional therapy.
• Other types of orthognathic (jaw) surgery that do not involve segmentation.

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel any pain. Postoperatively, there will likely be discomfort, swelling, and bruising, which can be managed with prescribed pain medications. Most patients experience significant improvement in function and appearance as they recover.