Lakin Gregory E, Kawamoto Henry K
Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine, University of California-Los Angeles, Santa Monica, CA 90404, USA.
J Craniofac Surg. 2012 Nov;23(7 Suppl 1):1964-7. doi: 10.1097/SCS.0b013e31825b351d.
In comparison with the abundant literature on Le Fort I and III osteotomies, there is scant information on the Le Fort II osteotomy. Our goal in this study was to define the indications and techniques of the elective Le Fort II osteotomy. We reviewed our 30-year experience, which is the longest series of patients treated with Le Fort II osteotomies at a single institution.
A review of the records of 13 consecutive patients at our institution with a diagnosis of Le Fort II was conducted. Data analyzed included demographic information, indications, techniques, complications, and combined procedures. On the basis of surgical outcomes, a treatment algorithm was created.
Thirteen patients had a diagnosis of Le Fort II at our institution. Five were excluded because of incomplete records or Le Fort II fracture repair. Three patients were male, and 5 were female. Their average age was 23 years, and the average follow-up was 60 months. Indications included nasomaxillary deviation related to unilateral coronal synostosis, hemifacial microsomia, Romberg disease, and noncleft nasomaxillary hypoplasia. The average estimated blood loss was 950 mL. Complications were persistent nasal deviation, temporary nasal obstruction, and a hematoma. Complementary procedures included bilateral sagittal split osteotomies, bone grafts, Le Fort I osteotomy, and repositioning of the zygoma.
On the basis of this review, we have elucidated the indications and less invasive techniques of the elective Le Fort II osteotomy. No major complications were observed. A management algorithm for performing the Le Fort II osteotomy is presented.
与关于Le Fort I型和III型截骨术的丰富文献相比，关于Le Fort II型截骨术的信息却很少。本研究的目的是明确择期Le Fort II型截骨术的适应证和技术。我们回顾了我们30年的经验，这是单一机构治疗Le Fort II型截骨术患者的最长系列。
对我们机构连续13例诊断为Le Fort II型的患者记录进行回顾。分析的数据包括人口统计学信息、适应证、技术、并发症和联合手术。根据手术结果创建了一种治疗算法。
我们机构有13例患者诊断为Le Fort II型。5例因记录不完整或Le Fort II型骨折修复而被排除。3例为男性，5例为女性。他们的平均年龄为23岁，平均随访时间为60个月。适应证包括与单侧冠状缝早闭、半侧颜面短小畸形、Romberg病和非腭裂性鼻上颌骨发育不全相关的鼻上颌骨偏斜。平均估计失血量为950毫升。并发症为持续性鼻偏斜、暂时性鼻塞和血肿。辅助手术包括双侧矢状劈开截骨术、植骨、Le Fort I型截骨术和颧骨重新定位。
基于本综述，我们阐明了择期Le Fort II型截骨术的适应证和微创技术。未观察到重大并发症。提出了一种进行Le Fort II型截骨术的管理算法。
