A modified occlusal splint to avoid tracheotomy for total midface osteotomies.

A modified occlusal splint is described which may be used to avoid tracheostomy when a total midface osteotomy is required. We demonstrate the accuracy of the modified splint by using the technique in a control subject who underwent alginate impressions, dental casts, and a face-bow transfer. A modified splint was constructed on the articulated dental models and was found to be accurate within the range of rotational movement of the temporomandibular joint. The technique is demonstrated in a patient with Crouzon's syndrome undergoing cranial vault reshaping and a monobloc (midface) advancement. The modified occlusal splint provides an alternative method of airway management when precise intraoperative occlusal relationships are important.