Rushinek H, Lavi A, Casap N
Refuat Hapeh Vehashinayim (1993). 2016 Jul;33(3):9-12, 69.
Orthognathic surgeries in which mobilization of the maxilla is required, are common procedures in the treatment of skeletal and developmental facial abnormalities. The Le fort I osteotomy is currently a safe, reliable and predictable procedure granting the surgeon good visualization and approach. However, these surgeries often involve substantial post operative swelling and pain, mostly due to the relatively extensive size of the mucoperiosteal approach flap. Several techniques have been previously reported in the literature, describing alternative approaches and novel instruments in an effort to reduce the intraoperative and postoperative challenges and complications of current surgical modalities. In this article we present a brief review of past and present maxillary osteotomy surgeries and describe our experience with a modified minimally invasive surgery in which approach to the maxilla is obtained through a smaller flap above the incisors, enabling sufficient osteotomy access, while limiting the extent of required surgical incisions and related post-operative complications.
需要上颌骨松动的正颌手术是治疗骨骼和发育性面部畸形的常见手术。目前，Le fort I 截骨术是一种安全、可靠且可预测的手术，能为外科医生提供良好的视野和入路。然而，这些手术术后常伴有明显的肿胀和疼痛，主要是由于粘骨膜入路皮瓣相对较大。此前文献中已报道了多种技术，描述了替代入路和新型器械，以努力减少当前手术方式的术中和术后挑战及并发症。在本文中，我们简要回顾过去和现在的上颌骨截骨手术，并描述我们采用改良微创手术的经验，即通过切牙上方较小的皮瓣对上颌骨进行入路，既能获得足够的截骨操作空间，又能限制所需手术切口的范围及相关术后并发症。
