Latitude and limitation of midface movements.

The starting point of midface osteotomies has been traced back to the last century (Cheever, 1867) by Moloney and Worthington (1981). Only occasional case reports can be found in the first half of this century. When Obwegeser (1962, 1965, 1969) described his standard approach to mobilise the maxilla, Tessier (1967, 1971a) discussed his extensive experience with the total midface advancement and finally Kufner (1971) and Souyris et al. (1973) proposed an intermediate midface osteotomy and Henderson and Jackson (1973) an approach to mobilise the midface according to a Le Fort II type osteotomy, the cornerstones were set further to develop techniques and modifications to solve functional and aesthetic needs of any patient with a midface deformity. The purpose of this paper is to discuss the actual knowledge of these basic procedures and their combinations, and to give a personal view on latitude and limitations concerning the planning, operative technique and results in treatment of deformities of the middle third of the face.