Preserving the pterygoid plates in posterior repositioning of the Le Fort I osteotomy

Summary The pterygoid plates have to be fractured and displaced to allow the maxilla to be repositioned posteriorly in the Le Fort I push-back osteotomy. A technique to reposition the maxilla posteriorly while preserving the pterygoid plates and the greater palatine neurovascular bundle is described. This technique reduces the risk of damaging the internal maxillary artery and the internal jugular vein which can lead to excessive haemorrhage. The disturbance to the Eustachian apparatus is also minimized.