Posnick J C, Ewing M P
Department of Surgery, Hospital for Sick Children, Toronto, Ontario, Canada.
Plast Reconstr Surg. 1990 May;85(5):706-10. doi: 10.1097/00006534-199005000-00009.
Outcomes in 30 adults and adolescents judged skeletally mature who had unilateral cleft lip and palate and underwent Le Fort I advancement were investigated to determine amount and timing of relapse, correlation between advancement and relapse, effect of performing multiple jaw procedures, effect of different types of bone grafts, effect of pharyngoplasty in place at the time of osteotomy, and effectiveness of various methods of internal fixation. Tracings of preoperative and serial postoperative lateral cephalograms were digitized to calculate horizontal and vertical maxillary changes. No significant differences in outcome was seen between patients who had maxillary surgery alone and those who had operations on both jaws, nor did the outcome vary significantly with the type of autogenous bone graft used or the segmentalization of the Le Fort osteotomy. Mean "effective" advancement was greater immediately and 2 years after surgery in those patients who did not have a pharyngoplasty in place before the operation. Advancement also was greater immediately and after 2 years in the miniplate fixation group than in patients with direct-wire fixation. Mean downward (vertical) displacement was 2.6 mm with a relapse of 1.4 mm after 2 years. Amounts of relapse and of advancement or displacement did not correlate significantly.
对30例经判断骨骼成熟的单侧唇腭裂成年和青少年患者进行了研究，这些患者接受了Le Fort I型前徙术，以确定复发的程度和时间、前徙与复发之间的相关性、进行多颌手术的影响、不同类型骨移植的影响、截骨时同期咽成形术的影响以及各种内固定方法的有效性。术前和术后系列头颅侧位片的描图经数字化处理，以计算上颌骨的水平和垂直变化。单纯上颌手术患者与双颌手术患者之间的结果无显著差异，使用的自体骨移植类型或Le Fort截骨的分段方式对结果也无显著影响。术前未同期进行咽成形术的患者，术后即刻及术后2年的平均“有效”前徙量更大。微型钢板固定组术后即刻及术后2年的前徙量也大于直接钢丝固定患者。平均向下（垂直）移位为2.6 mm，2年后复发1.4 mm。复发量与前徙量或移位量之间无显著相关性。
