Hiranuma Y, Yamamoto Y, Iizuka T
Department of Oral Surgery, School of Dentistry, Josai Dental University, Sakado, Japan.
J Craniomaxillofac Surg. 1988 Jan;16(1):13-7. doi: 10.1016/s1010-5182(88)80007-6.
In the Le Fort I type osteotomy, separation of the pterygomaxillary suture is a dangerous manoeuvre which must be carried out during the surgical procedure. To determine the osteotome best suited for safe separation of the pterygomaxillary suture, we measured the strain distribution over the surrounding bone structures during the osteotomy, employing two types of osteotomes. In both the Obwegeser osteotome group and swan's neck osteotome group, a large strain was measured at the medial pterygoid plate on the side of osteotome application. The intensity of the strain at the medial pterygoid plate was higher in the Obwegeser osteotome group than in the swan's neck group. With the Obwegeser osteotome which is routinely and commonly used in orthognathic surgery, safe separation of the suture cannot be accomplished unless the blade is correctly applied to the suture and superoposterior compression of the pterygoid process is avoided.
在Le Fort I型截骨术中，翼上颌缝的分离是一种危险的操作，必须在手术过程中进行。为了确定最适合安全分离翼上颌缝的骨凿，我们在截骨过程中使用两种类型的骨凿，测量了周围骨结构上的应变分布。在Obwegeser骨凿组和天鹅颈骨凿组中，在应用骨凿一侧的翼内侧板处均测量到较大应变。Obwegeser骨凿组翼内侧板处的应变强度高于天鹅颈组。使用正颌手术中常规且常用的Obwegeser骨凿时，除非刀片正确应用于缝线并避免翼突的后上压缩，否则无法实现缝线的安全分离。
