Cheever's double operation: the first Le Fort I osteotomy.

Abstract

In 1868, David Williams Cheever of Boston performed a daring operation, now known as a Le Fort I osteotomy, to expose and remove a large nasopharyngeal polyp. His published account described osteotomies 31 years before Le Fort's articles on experimental facial fracture lines, and remains the earliest description of this procedure. German and French surgeons had been treating similar polyps via hemimaxillary osteotomy. Because Cheever performed bilateral osteotomies, his technique became known as Cheever's "double operation." Cheever went on to become a prominent Boston surgeon, playing a pivotal role in the development of Boston City Hospital. He eventually became chair in surgery at Harvard Medical School, succeeding Bigelow and preceding J. Collins Warren at the Massachusetts General Hospital. He was also editor of the Boston Medical and Surgical Journal (a predecessor of the New England Journal of Medicine) and president of the American Surgical Association. Although Cheever's contributions have been recognized, little has been written about the life of this forgotten pioneer in American craniofacial surgery, nor the surgical and historical context in which his "double operation" was developed.