ABSTRACT
Maxillary osteotomy allows independent repositioning of the maxilla in three dimensions and so can correct skeletal deformity of the midface. The history of this commonly utilised orthognathic procedure is diverse. The paired maxillae comprises a pneumatised pyramidal body and four projections: the alveolar, palatine, zygomatic and frontal processes. Fusing at the midline intermaxillary suture, this bony structure forms the upper jaw supporting the maxillary teeth but also forms the orbit, nose and palate. Maxillary blood supply is via branches of the maxillary artery, including the descending palatine artery which can be disrupted by Le Fort I osteotomy, or preserved with care. If there are maxillary and zygomatic deficiencies in patients who have normal nasal projection, a high or quadrangular Le Fort I can be used. This cut extends higher on the anterior wall of the maxilla and body of zygoma, avoiding the infraorbital nerve.
