Minimally Invasive (MI) Mandible Constriction/Expansion

Step-by-step standardization of minimally invasive (MI) orthognathic surgical techniques increases surgical efficiency and decreases patient morbidity. In this chapter, an innovative systematized “5 step-by-step approach” toward mandible constriction or expansion following a "MI philosophy and mindset” is outlined in detail. General considerations regarding the preparation of the patient, instrumentation table, and operating room toward MI mandible constriction or expansion are well described. Dedicated new developed MI orthognathic surgical instruments allow to optimize the vascular blood supply and decrease of interstitial edema and swelling after mandible constriction or expansion which enhances postoperative fast recovery of the patient. Moreover, the introduction of MI orthognathic surgical codes and MI orthognathic surgical sequences creates a common language among the surgical team (operating surgeon, surgical assistants, and operating nurse) which increases surgical efficiency and additionally decreases patient morbidity. Furthermore, systematization of storage of the MI orthognathic instruments allows to optimize their gathering, cleaning, and sterilization process toward a more time-efficient and cost-effective clinical routine. Every single step of the MI approach toward the mandible constriction or expansion surgical procedure is illustrated in detail by high-quality graphic illustrations and pictures made on synthetic skulls and human cadavers. Finally, the limits of the described MI surgical technique toward maxillary expansion are summarized.