Maxillary deformities.

The management of congenital maxillary anomalies can be managed with ease by the well trained facial plastic surgeon. An understanding of dental anatomy, occlusion, and the rudiments of cephalometric analysis are important prerequisites for this type of work. A background in the management of facial trauma prepares the surgeon for the surgery involved. A sense of aesthetics is required to adequately anticipate what the final cosmetic and functional outcome should be in these cases. The Le Fort III osteotomy is particularly difficult, especially if there is associated hypertelorism that requires craniotomy. Significant experience in the less demanding operations of the maxilla coupled with experience in skull base surgery is essential before tackling this demanding procedure.