Brusati R, Sesenna E, Raffaini M
Dept. of Maxillo-Facial Surgery, University and Hospital of Parma, Italy.
J Craniomaxillofac Surg. 1989 Apr;17(3):110-5. doi: 10.1016/s1010-5182(89)80081-2.
The maxillo-malar osteotomy is one of the osteotomies developed over the years to correct the deformities of the midface without modifying the nasal projection. After having for many years approached the osteotomy through the classic double access, intraoral and subciliary, we verified the feasibility of this osteotomy via an intraoral route only. For this purpose we modified slightly the classic osteotomy lines, however still including in the mobilized fragment the most prominent and therefore the most aesthetically important portion of the zygoma. At the lower orbital rim the medial osteotomy cut is performed with a fissure bur, the lateral one with an oscillating saw. Both the osteotomies are extended posteriorly in the orbital floor with a fine osteotome. Then, after having performed all other osteotomy cuts, the maxillo-malar complex is down-fractured. The residual thin bone structures which connect the maxillo-malar complex to the cranio-facial skeleton are broken during a careful downfracture, avoiding fracture between the maxilla and zygoma. The complex is advanced and stabilized with intermaxillary fixation, osteosynthesis and bone grafts. A bone graft to the orbital floor is unnecessary.
上颌-颧骨截骨术是多年来发展起来的用于矫正中面部畸形而不改变鼻突度的截骨术之一。在多年来通过经典的口内和睫下双入路进行截骨术后，我们验证了仅通过口内途径进行这种截骨术的可行性。为此，我们对经典的截骨线进行了轻微修改，但仍在移动骨块中包含颧骨最突出且因此在美学上最重要的部分。在下眶缘，内侧截骨用裂钻进行，外侧用摆动锯进行。两条截骨线均用精细骨凿在眶底向后延伸。然后，在完成所有其他截骨切口后，将上颌-颧骨复合体向下折断。在小心向下折断过程中，连接上颌-颧骨复合体与颅面骨骼的残留薄骨结构会断裂，避免上颌骨和颧骨之间的骨折。该复合体通过颌间固定、骨固定和骨移植推进并固定。无需对眶底进行骨移植。
