Skip to main content
2024 AAOMS 106th Annual Meeting Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
Ticketed <br><i>This session/event requires a ticket.</i>
Ticketed
This session/event requires a ticket.
In-person only<br><i>This session is offered in-person only.</i>
In-person only
This session is offered in-person only.
On-demand<br><i>On-demand session available beginning Sept. 9.</i>
On-demand
On-demand session available beginning Sept. 9.
Recorded<br><i>This session will be recorded and available beginning Sept. 30.</i>
Recorded
This session will be recorded and available beginning Sept. 30.
Sold Out<br><i>This ticketed session/event is sold out.</i>
Sold Out
This ticketed session/event is sold out.
2024 Oral Abstract Award
2024 Oral Abstract Award
Poster Icons
Poster Winner
Poster Winner
Back

Cleft & Craniofacial Surgery

(8) An Algorithm Utilizing Premaxillary Osteotomy in the Management of Patients With Bilateral Cleft Lip

Thursday, September 12, 2024
2:30 PM – 4:00 PM EDT

    Poster Presenter(s)

  • Marah Jolibois, MS (she/her/hers)

    Research Fellow
    Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles
    Los Angeles, California, United States

    • Co-Author(s)

  • Sasha Lasky, BS

    Research Fellow
    Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles
    South Pasadena, California, United States

  • Idean Roohani, BS

    Research Fellow
    Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles
    Los Angeles, California, United States

  • Tayla Moshal, BS

    Research Fellow
    Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles
    Los Angeles, California, United States

  • LF

    Lacey Foster, BS

    Medical Student
    Keck School of Medicine
    Los Angeles, California, United States

  • MU

    Mark M. Urata, DDS, MD

    Plastic Surgeon Attending
    Division of Plastic and Maxillofacial Surgery, Children’s Hospital Los Angeles
    Los Angeles, California, United States

  • WM

    William P. Magee, III, DDS, MD

    Plastic Surgeon Attending
    Division of Plastic and Maxillofacial Surgery, Children’s Hospital Los Angeles
    Los Angeles, California, United States

  • Jeffrey A. Hammoudeh, DDS, MD

    Plastic Surgeon Attending
    Division of Plastic and Maxillofacial Surgery, Children’s Hospital Los Angeles
    Los Angeles, California, United States

Disclosure(s):
Sasha Lasky, BS: No financial relationships to disclose
Tayla Moshal, BS: No financial relationships to disclose
Abstract

Background: This study analyzes indications and outcomes for premaxillary osteotomy (PO) and presents an algorithm for its use in the management of patients with bilateral cleft lip (BCL).

Methods: A retrospective review was conducted evaluating patients undergoing lip repair at our institution from 2003-2023. Patients with BCL with or without cleft palate who underwent lip repair with simultaneous PO (BCL+PO) or without PO (BCL-PO). Premaxillary setback was chosen based on an algorithm that incorporated time of presentation and success of nasoalveolar molding (NAM). Indications for premaxillary setback, timing of surgery, complications, and the need for orthognathic surgery to correct midface hypoplasia assessed at 14 years of age were collected.

Results: 1,090 patients who underwent cleft lip repair were identified, of which 266 patients with BCL/P met inclusion criteria. Of these, 51 patients required premaxillary setback. Based on these results, a management algorithm was developed (Figure 1). One hundred forty-nine patients with complete BCL/P were recommended NAM. For patients with a protruding premaxilla who failed treatment (n = 12) or were not deemed candidates of NAM (n = 31), premaxillary setback was recommended (6.056±4.682 months). Patients with a protruding premaxilla who presented to our institution late were also recommended premaxillary setback (n = 8, 12.977± 8.196 months). Across all patients, complications included wound dehiscence (n = 3) and abscess formation (n = 2). Notably, there were no instances of avascular necrosis of the premaxilla. Compared to BCL-PS, BCL+PS had comparable rates of wound dehiscence (2.7%vs. 7.7%; P = .932), lip revisions (10% vs. 11.3%; P = .976), and orthognathic surgery rates ( 50% vs. 56.3%; P > .999).

Conclusion: This algorithm provides safe experiential-based guidance for the management of the premaxillary segment.References Stanton E, Kondra K, Jimenez C, Shakoori P, Yen S, Urata MM, Hammoudeh JA, Magee WP 3rd. Premaxillary Setback in Bilateral Cleft Lip and Palate Repair. Cleft Palate Craniofac J. 2024 Mar;61(3):416-421. doi: 10.1177/10556656221130166. Epub 2022 Nov 29. PMID: 36448087.

An Algorithm Utilizing Premaxillary Osteotomy