Lee Seung-Hun, Lee Sang-Han, Mori Yoshihide, Minami Katsuhiro, Park Hyo-Sang, Kwon Tae-Geon
Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Daegu, Korea.
J Oral Maxillofac Surg. 2011 Oct;69(10):2644-9. doi: 10.1016/j.joms.2011.01.004. Epub 2011 Apr 15.
Structural characteristics of the pterygomaxillary region in patients with cleft lip and palate (CLP) have not been fully investigated. This study aimed to evaluate the regional anatomy of the pterygomaxillary junction of patients with CLP using computed tomography.
The pterygomaxillary structures of patients with unilateral or bilateral CLP were compared with those of a control group using axial computed tomography. The thickness and width of the pterygoid plate, the distance from the greater palatine foramen to the lateral pterygomaxillary junction, the lateral and medial pterygoid plate lengths, and the maxillary posterior transverse width were investigated with axial computed tomography just beneath the level of the inferior nasal concha and approximately 3 to 5 mm above the nasal floor. The difference between the cleft and noncleft sides or the right and left sides of each group and the measurement differences between the groups were statistically compared.
The study group was composed of 14 patients with unilateral CLP and 6 with bilateral CLP, and the control group were 20 age- and gender-matched patients with skeletal Class III without CLP. Patients with unilateral CLP and those with bilateral CLP were statistically equivalent for all radiographic variables. In patients with CLP, the width of the pterygomaxillary region and the greater palatine foramen region were on average 1.5 to 1.8 mm larger than in control patients (P < .05). Lateral pterygoid plate length and maxillary posterior transverse width were similar in the 2 groups. However, the patients with CLP showed a 2.3-mm shorter medial pterygoid length (P < .05).
Patients with CLP had larger and thicker pterygomaxillary dimensions, and the results imply that careful attention to pterygomaxillary anatomy is needed in patients with CLP undergoing Le Fort I surgery.
唇腭裂（CLP）患者翼上颌区域的结构特征尚未得到充分研究。本研究旨在使用计算机断层扫描评估CLP患者翼上颌交界处的局部解剖结构。
使用轴向计算机断层扫描，将单侧或双侧CLP患者的翼上颌结构与对照组进行比较。在下鼻甲水平下方且鼻底上方约3至5毫米处，通过轴向计算机断层扫描研究翼突板的厚度和宽度、腭大孔至翼上颌外侧交界处的距离、翼突内外侧板长度以及上颌后横径。对每组裂隙侧与非裂隙侧或左右侧之间的差异以及组间测量差异进行统计学比较。
研究组由14例单侧CLP患者和6例双侧CLP患者组成，对照组为20例年龄和性别匹配的无CLP的骨性III类患者。单侧CLP患者和双侧CLP患者在所有影像学变量上在统计学上相当。CLP患者的翼上颌区域和腭大孔区域的宽度平均比对照患者大1.5至1.8毫米（P <.05）。两组的翼外板长度和上颌后横径相似。然而，CLP患者的翼内肌长度短2.3毫米（P <.05）。
CLP患者的翼上颌尺寸更大且更厚，结果表明接受Le Fort I手术的CLP患者需要仔细关注翼上颌解剖结构。
