Modification of LeFort I osteotomy for severe maxillary vertical excess asymmetry.

A superfluous maxillary alveolus exacerbates excess of the vertical maxilla, and leads to a severe form of deformity. This poses a unique surgical challenge. In such conditions, the dimensions of the maxilla cephalad to the anterior nasal spine are normal, which limits superior repositioning of the maxilla when done in a conventional manner. The objective of this paper is to highlight the importance of a modified approach to this deformity using a subnasal maxillary osteotomy. Advantages of subspinal maxillary osteotomy include the reduction of maxillary alveolar excess and increase in the scope for maxillary impaction.