Bu B H, Kaban L B, Vargervik K
University of California, San Francisco 94143.
J Oral Maxillofac Surg. 1989 Jul;47(7):666-71. doi: 10.1016/s0278-2391(89)80002-3.
Midface advancement by Le Fort III osteotomy is a common procedure in craniofacial surgery. However, little data exist concerning the effect of midface advancement on mandibular growth. This is a retrospective study of 38 patients from two craniofacial centers who had Le Fort III osteotomy. The aims of this investigation were to document the size and shape of the mandible in Crouzon and Apert syndromes and to determine the effect on these parameters of downward and forward movement of the midface. The syndrome patients had increased gonial angle, increased MP-SN, increased ramus height, and increased ratio of ramus height to body length when compared with normal standards. Patients operated during growth and those operated when growth was completed had similar mandibular size and shape indicating that Le Fort III osteotomy had no measurable effect on these parameters. Inclination of the mandible to the anterior cranial base was increased by the operation and remained unchanged during the follow-up period. The results of this study indicate that the size and morphology of the mandible are similar in Crouzon and Apert syndromes. The pattern of growth is more vertical in the syndrome patients than in normals. Le Fort III osteotomy in growing children does not result in altered mandibular size and shape despite backward rotation of the mandible as a result of midface advancement.
通过Le Fort III截骨术进行面中部前移是颅面外科的常见手术。然而，关于面中部前移对下颌骨生长影响的数据很少。这是一项对来自两个颅面中心的38例行Le Fort III截骨术患者的回顾性研究。本研究的目的是记录克鲁宗综合征和阿佩尔综合征患者下颌骨的大小和形状，并确定面中部向下和向前移动对这些参数的影响。与正常标准相比，综合征患者的下颌角增大、下颌平面角（MP-SN）增大、升支高度增加以及升支高度与体长的比值增加。在生长期间接受手术的患者和生长完成后接受手术的患者下颌骨大小和形状相似，这表明Le Fort III截骨术对这些参数没有可测量的影响。手术使下颌骨相对于前颅底的倾斜度增加，且在随访期间保持不变。本研究结果表明，克鲁宗综合征和阿佩尔综合征患者的下颌骨大小和形态相似。综合征患者的生长模式比正常人更垂直。尽管面中部前移导致下颌骨向后旋转，但对正在生长的儿童进行Le Fort III截骨术并不会导致下颌骨大小和形状改变。
