Kang Stephen Y, Lin Erin M, Marentette Lawrence J
Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan.
Skull Base. 2009 Jul;19(4):273-7. doi: 10.1055/s-0029-1220198.
This article reports on the presence of an anatomic feature of the extracranial skull base that may result in internal carotid artery injury if secure and complete pterygomaxillary separation is not achieved before maxillary downfracture in the Le Fort I osteotomy. The extracranial skull base of 129 adult skulls and 10 pediatric skulls was examined in the region near the foramen lacerum. This region was inspected for the presence or absence of a bony protrusion that projected posteriorly from the base of the sphenoid, lying inferior to the foramen lacerum. The bony protrusion was present bilaterally in 71% of the adult skulls and 60% of the pediatric skulls. The protrusion was a bony "spike" that pointed posteriorly and was located inferior to the foramen lacerum on the extracranial skull base. Due to its size, shape, and location, the bony protrusion described in this study poses considerable risk to the internal carotid artery if the protrusion is displaced superiorly through the foramen lacerum. In the Le Fort I osteotomy, secure and complete pterygomaxillary separation is crucial to avoid injury to the internal carotid artery during maxillary downfracture.
本文报道了颅外颅底的一种解剖学特征，如果在Le Fort I型截骨术中上颌骨向下折断之前未实现翼上颌的牢固且完全分离，可能会导致颈内动脉损伤。对129个成人颅骨和10个儿童颅骨的颅外颅底在破裂孔附近区域进行了检查。检查该区域是否存在从蝶骨底部向后突出、位于破裂孔下方的骨性突起。在71%的成人颅骨和60%的儿童颅骨中双侧存在该骨性突起。该突起是一个向后指向的骨性“尖刺”，位于颅外颅底破裂孔下方。由于其大小、形状和位置，如果该骨性突起向上移位穿过破裂孔，本研究中描述的骨性突起会对颈内动脉构成相当大的风险。在Le Fort I型截骨术中，牢固且完全的翼上颌分离对于避免上颌骨向下折断过程中颈内动脉损伤至关重要。
