A Comprehensive Strategy for Reconstruction of a Missing Midface.

The loss of midface structures always leads to significant functional and cosmetic deficits, and the reconstruction work remains a challenge for surgeons. We report a rare case with severe midfacial defects involving the maxilla, nasal bone, and zygoma. This patient was treated with a comprehensive approach that included distraction osteogenesis, computer-aided surgery, a fibula bone graft, dental implantation, orthognathic surgery, and rhinoplasty. The treatment procedures required 4 years to complete, and a dramatically improved facial contour and stable occlusion were achieved. The results demonstrated the importance of a multidisciplinary approach and computer-aided design when treating severe maxillofacial deformities. Other important elements of the treatment process were the meticulous physical examination, the selection of an optimal treatment sequence, the skill of the surgeons, and more importantly, the patient-oriented mindset.