Freihofer H P, van Damme P A, Kuijpers-Jagtman A M
Dept. Oral and Maxillo-Facial Surgery, University Hospital Nijmegen, The Netherlands.
J Craniomaxillofac Surg. 1991 Jan;19(1):2-6. doi: 10.1016/s1010-5182(05)80264-1.
Using the same arguments as for early bone grafting of the alveolar process in unilateral clefts, the cleft team of the University of Nijmegen started about 10 years ago to apply early osteotomy-stabilization of the premaxilla to bilateral clefts. A series of 13 cases with a minimum follow-up of 15 months is presented. The patients were operated on at the age of 8 2/12 to 12 5/12 years. The results are considerably better than when doing the same operation in the adult. More than 90% are successful. In comparison with adults we additionally register more favourable eruption of the canine, the possibility of closing the dental arch without prosthetic appliances and in some cases also the elimination of a psychological handicap. The inhibition of growth by this operation seems not to be important. If need be, Le Fort I osteotomies are possible after completion of growth. They will be in one piece which is technically easier than the usual three-segment Le Fort I. In conclusion we prefer early secondary osteotomy and stabilization of the premaxilla to the tertiary operation.
使用与单侧唇腭裂患者牙槽突早期植骨相同的论据，奈梅亨大学的腭裂治疗团队大约在10年前开始将早期上颌前突截骨稳定术应用于双侧唇腭裂患者。本文报告了13例患者的系列病例，随访时间最短为15个月。患者手术时年龄在8又2/12岁至12又5/12岁之间。结果比在成人中进行相同手术要好得多。成功率超过90%。与成人相比，我们还记录到犬齿萌出更有利，无需修复器具即可关闭牙弓，在某些情况下还消除了心理障碍。该手术对生长的抑制作用似乎并不重要。如有需要，生长完成后可行勒福I型截骨术。截骨块将是完整的一块，在技术上比通常的三段式勒福I型截骨术更容易。总之，与三期手术相比，我们更倾向于早期二期上颌前突截骨稳定术。
