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“改良斜行Le Fort III型截骨术”新概念

"Modified Oblique Le Fort III Osteotomy" New Concepts.

作者信息

García Y Sánchez J M, Romero Flores J, Gómez Rodríguez C L, Pacheco Rubio G, Rosales Díaz Mirón D, Hernández Miranda A

机构信息

Maxillofacial Surgery Service, Specialty Hospital, National Medical Center XXI Century, IMSS, Avenida Cuahtemoc, #330, Colonia Doctores, Mexico, Distrito Federal Mexico.

出版信息

J Maxillofac Oral Surg. 2017 Mar;16(1):22-42. doi: 10.1007/s12663-016-0893-7. Epub 2016 May 13.

Abstract

INTRODUCTION

The purpose of this study is to demonstrate the surgical technique for the correction of midfacial deformities; vertical excess and posteroanterior hypoplasia. This situation obligates the need to move the whole osseous structure in an oblique posteroanterior movement that should correct both midfacial deformities. This should also correct the lip incompetence while improving the malar projection on a profile view of the patient. We also present a mathematical formula that gives the angulation needed for moving the midface complex in a simultaneous vertical and posteroanterior direction. Once given the correct angulation for the desired oblique movement, the surgeon can reproduce this angulation with custom made surgical guides over the stereolithographic model, that can then be used during surgery to achieve the desired movement accurately. This technique exemplified on this paper will give maxillofacial surgeons a new and affordable tool for the correction of midfacial deformities in an accurate and easily reproducible manner and amplifying the surgical repertoire.

MATERIALS AND METHODS

Patients seen in the specialty hospital "Dr. Bernardo Sepulveda" National Medical Center XXI Century, IMSS, during the period from February 2013 to November 2014 with Modified Oblique Le Fort III osteotomies, with the application of two trigonometric formulas for the accuracy of the technique.

CONCLUSIONS

The application of the formulas give accurate results as well as the enlargement of the upper airway and esthetic results.

摘要

引言

本研究的目的是展示用于矫正面中部畸形(垂直过度和前后发育不全)的手术技术。这种情况需要将整个骨结构进行斜向前后移动,以矫正这两种面中部畸形。这还应纠正唇部闭合不全,同时在患者侧位像上改善颧骨突出度。我们还提出了一个数学公式,该公式给出了在垂直和前后方向同时移动面中部复合体所需的角度。一旦给出了所需斜向移动的正确角度,外科医生就可以在立体光刻模型上使用定制的手术导板重现这个角度,然后在手术中使用该导板精确实现所需的移动。本文所举例的这项技术将为颌面外科医生提供一种新的、经济实惠的工具,以准确且易于重现的方式矫正面中部畸形,并丰富手术方法。

材料与方法

2013年2月至2014年11月期间,在墨西哥社会保险局21世纪国家医学中心“贝尔纳多·塞普尔韦达医生”专科医院就诊的患者接受了改良斜行勒福Ⅲ型截骨术,并应用了两个三角公式以确保技术的准确性。

结论

公式的应用产生了准确的结果,同时扩大了上呼吸道并改善了美观效果。

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本文引用的文献

1
Surgical Guides for Modified Oblique Le Fort III Osteotomy.改良斜行Le Fort III型截骨术的手术指南
J Maxillofac Oral Surg. 2015 Jun;14(2):487-96. doi: 10.1007/s12663-014-0620-1. Epub 2014 Mar 19.

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