Lehman J A, Haas A J
Northeastern Ohio Universities College of Medicine, Akron.
Dent Clin North Am. 1990 Apr;34(2):385-95.
A conservative osteotomy of the zygomaticomaxillary buttress in combination with a rapid palatal expansion appliance is a dependable technique for the treatment of horizontal maxillary deficiency in adults. This procedure has been used successfully in 56 patients in our series, but 17 patients (30 per cent) required a midpalatal osteotomy. In two patients, overexpansion was not achieved because of necrosis of the mucosa. In three other patients, expansion had to proceed at a slower pace because of mucosal ulceration. There have been no other complications. The procedure is indicated mainly in those patients with a horizontal deficiency who do not require subsequent surgery, but for some patients it may be the preliminary procedure. Twelve patients (21 per cent) had subsequent orthognathic surgery. Follow-up has been from 1 to 12 years and there has been no relapse. In our opinion, the zygomaticomaxillary buttress is the primary area of resistance to lateral movement of the maxilla by rapid maxillary expansion appliances.
颧上颌支柱保守性截骨术联合快速腭扩展矫治器是治疗成人上颌骨水平向发育不足的可靠技术。该手术在我们的系列研究中已成功应用于56例患者，但有17例患者（30%）需要进行腭中缝截骨术。2例患者因黏膜坏死未实现过度扩展。另外3例患者因黏膜溃疡，扩展速度不得不放慢。未出现其他并发症。该手术主要适用于那些不需要后续手术的水平向发育不足患者，但对一些患者而言，它可能是初步手术。12例患者（21%）接受了后续正颌手术。随访时间为1至12年，未出现复发情况。我们认为，颧上颌支柱是上颌骨通过快速上颌扩展矫治器向外侧移动的主要阻力部位。
