Department of Oral and Maxillofacial Surgery, İstanbul University Faculty of Dentistry, İstanbul-Türkiye.
Department of Oral and Maxillofacial Radiology, İstanbul University Faculty of Dentistry, İstanbul-Türkiye.
Ulus Travma Acil Cerrahi Derg. 2023 Feb;29(2):149-154. doi: 10.14744/tjtes.2022.45995.
Le Fort 1 (LF1) osteotomies are widely used to correct midface deformities. To move the maxilla freely, the ptery-gomaxillary junction (PMJ) must be separated. When performing this osteotomy, the pterygoid plate must remain intact. The objective of this study was to evaluate relationship between the anatomical features of the PMJ and fracture patterns in LF1 osteotomy.
Pre-operative and post-operative cone-beam computed tomography images of 41 patients (82 samples) who have undergone LF1 osteotomy surgery were radiologically evaluated. Morphologic measurements of the pterygomaxillary fissure area and pterygoid plate were carried out. Moreover, pterygomaxillary separation was divided into the clean-cut, maxillary sinus, and pterygoid plate fracture types.
Statistically significant difference was observed between clean-type fracture and pterygoid plate fracture groups' thickness of the pterygoid process and thickness of the pterygomaxillary region.
Anatomical variations make it difficult to separate the PMJ properly. Low thickness of PMJ increases the risk of unwanted fractures; however, according to our experience, the use of an osteotome with an incorrect angle, excessive force, and inexperienced surgeons can also cause undesirable pterygoid plate fractures.
Le Fort 1（LF1）截骨术广泛用于矫正面中部畸形。为了自由移动上颌骨，必须分离翼腭关节（PMJ）。进行这种截骨术时，翼状板必须保持完整。本研究的目的是评估 PMJ 的解剖特征与 LF1 截骨术中骨折模式之间的关系。
对 41 例（82 例）接受 LF1 截骨术的患者的术前和术后锥形束 CT 图像进行影像学评估。对翼腭裂隙区和翼状板的形态进行测量。此外，将翼腭分离分为整齐型、上颌窦型和翼状板骨折型。
在翼状突厚度和翼腭区厚度方面，整齐型骨折组与翼状板骨折组之间存在统计学显著差异。
解剖变异使 PMJ 难以正确分离。PMJ 厚度较低会增加意外骨折的风险；然而，根据我们的经验，使用角度不正确、力过大和经验不足的外科医生的骨凿也会导致翼状板骨折。
