Wilson M W, Maheshwari P, Stokes K, Wheatley M J, McLoughlin S, Talbot M, Shults W T, Dailey R A, Wobig J L
Department of Ophthalmology, University of Tennessee, Memphis, College of Medicine, 38163, USA.
Ophthalmic Plast Reconstr Surg. 2000 Jul;16(4):258-70. doi: 10.1097/00002341-200007000-00003.
To report the ophthalmic complications of Le Fort I osteotomy for the correction of dentofacial deformities and to determine the maximal compressive loads applied during pterygomaxillary separation in a cadaver model.
Two cases of ophthalmic complications arising after Le Fort I osteotomy are reported. Le Fort I osteotomy was performed on five cadavers. The maximal compressive load applied during pterygomaxillary separation was recorded with a 10 kN (3,000 lbf) load cell of a MTS Mini-Bionix servo-hydraulic machine (MTS, Eden Prairie, MN, U.S.A.). A paired t test was used to compare forces applied to the right and left sides. Computed tomography scans of each specimen were obtained after Le Fort I osteotomy to document secondary fractures. The skulls were subsequently stained with 1% fuschin red to highlight secondary fractures.
Maximum compressive loads during pterygomaxillary separation ranged from 22 N (5.0 lbf) to 162 N (36.5 lbf), with an average of 106 N (23.8 lbf) (SD 47.6 N [10.7 lbf]). Forces applied on the first operative side were significantly greater than forces applied on the second operative side (p = 0.0034). Secondary fractures were found in three specimens by computed tomography and in two specimens by 1% fuschin red. All secondary fractures occurred on the second operative side.
Secondary fractures in the Le Fort I osteotomy procedures occurred on the side opposite the greater maximal compressive load and on the second operative side.
报告用于矫正牙颌面畸形的Le Fort I型截骨术的眼科并发症，并在尸体模型中确定翼上颌分离过程中施加的最大压缩负荷。
报告了2例Le Fort I型截骨术后出现的眼科并发症。对5具尸体进行了Le Fort I型截骨术。使用美国明尼苏达州伊登草原市MTS公司的MTS Mini-Bionix伺服液压机的10 kN（3,000 lbf）测力传感器记录翼上颌分离过程中施加的最大压缩负荷。采用配对t检验比较左右两侧施加的力。在Le Fort I型截骨术后对每个标本进行计算机断层扫描，以记录继发性骨折。随后，对头骨用1%品红进行染色，以突出继发性骨折。
翼上颌分离过程中的最大压缩负荷范围为22 N（5.0 lbf）至162 N（36.5 lbf），平均为106 N（23.8 lbf）（标准差47.6 N [10.7 lbf]）。首次手术侧施加的力明显大于第二次手术侧施加的力（p = 0.0034）。通过计算机断层扫描在3个标本中发现继发性骨折，通过1%品红在2个标本中发现继发性骨折。所有继发性骨折均发生在第二次手术侧。
Le Fort I型截骨术过程中的继发性骨折发生在最大压缩负荷较大的一侧的对侧以及第二次手术侧。
