Volume 16, Number 2, June 2004

Extended Lateral Sliding Genioplasty for the Correction of Facial Asymmetry

Varghese Mani,1 Antony George,2 Prashanth Yethadkka Keshava,1 Bobby John,1 Saju Simon1

1Department of Oral and Maxillofacial Surgery, Government Dental College, Calicut, Kerala, and 2Trichur Institute of Head & Neck Surgery, Trichur, India


Abstract
Objective: To evaluate the efficacy of 'extended lateral sliding genioplasty' in improving facial balance, symmetry, and aesthetics for patients with facial asymmetry due to unilateral mandibular deficiency.
Patients and Methods: Sixty five patients with non-syndromic unilateral mandibular deficiency who were treated between January 1993 and March 2003 were included in the study. All patients underwent surgery consisting of an intraoral inferior border osteotomy (below the mandibular canal) to slide the lower segment forward and laterally as required. Standardised preoperative and postoperative frontal facial photographs were used to evaluate the extent of lateral translation and the angle of rotation of the segment. The ratios of distance from subnasale to upper lip stomion, upper lip stomion to menton, and the amount of skeletal and soft tissue advancement were calculated from lateral cephalograms.
Results: Mean lateral translation of the genioplasty segment was 10 mm (range, 5 to 12 mm) and the angle of rotation was 4º (range, 2 to 6º). The ratio of distance from subnasale to upper lip stomion and from upper lip stomion to menton decreased to approach normal. Forward movement of soft tissue and bony pogonion was achieved and the mean values were 0.9 cm and 1 cm, respectively.
Conclusion: Extended lateral sliding genioplasty is a versatile technique for the correction of facial asymmetry and retruded chin due to unilateral mandibular deficiency. This lengthens the deficient side and gives fullness to the sunken side, providing symmetry and balance. Since only the inferior part of the mandible is moved there is no disturbance of the existing occlusion.


Key words: Ankylosis, Facial asymmetry, Osteotomy, Temporomandibular joint disorders

Asian J Oral Maxillofac Surg. 2004;16:84-90.
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