Pergel T, Akkoyun E-F, Kasarcioglu G, Dolanmaz D
Bezmialem Vakif University Faculty of Dentistry Department of Oral and Maxillofacial Surgery Fatih, Istanbul, Turkey
Med Oral Patol Oral Cir Bucal. 2025 Mar 1;30(2):e297-e305. doi: 10.4317/medoral.26939.
The study aimed to investigate the effect of customized lateral nasal wall osteotomy (LNO) on the lateral nasal wall (LNW) and pterygomaxillary junction (PMJ) separation during Le Fort I. We hypothesized that customized LNO on the LNW affect the PMJ separation type.
This prospective, controlled, randomized study included forty-three patients were randomly assigned to either the conventional or customized (study) osteotomy groups. In the study group, LNW depth was measured before surgery in the axial section of the CT scan, and LNO was performed at a depth of 2 mm less than the measured distance. In the conventional osteotomy group, LNO was performed at 30 mm for females and 35 mm for males. Patients with cleft lip and palate, previous orthognathic surgery, or rhinoplasty were excluded. Separation types were classified as follows: LNW types; Type1-from the osteotomy line; Type2- 2-4 mm above the osteotomy line; Type3- 4 mm or more above the osteotomy line. PMJ types; Type1-including the tuber maxilla; Type2-from the pterygomaxillary junction; Type3-including the pterygoid plates. Chi-square tests were conducted to determine whether there was a significant correlation between groups and LNW separation types, groups and PMJ separation types and groups, and LNW separation type and PMJ separation type. A P value of < .05 was considered statistically significant.
In both the conventional (P=0.052) and the study groups (p=0.828), there was no significant difference between LNW depth. Type 1 (P=0.0003) and Type 2 (P=0.0051) LNW separation types presented a significant difference between groups. A chi-square test showed a significant correlation between the surgical groups and PMJ separation patterns (P<0.05).
Customized LNO optimizes the LNW and PMJ separation. Facilitates the Le Fort I surgery and decrease unintentional fracture of the PMJ.
本研究旨在探讨定制化鼻侧壁截骨术（LNO）对Le Fort I型截骨术中鼻侧壁（LNW）和翼上颌连接部（PMJ）分离的影响。我们假设在LNW上进行定制化LNO会影响PMJ的分离类型。
这项前瞻性、对照、随机研究纳入了43例患者，这些患者被随机分配至传统截骨组或定制（研究）截骨组。在研究组中，术前在CT扫描的轴位图像上测量LNW深度，LNO在比测量距离小2mm的深度进行。在传统截骨组中，女性LNO深度为30mm，男性为35mm。排除唇腭裂患者、既往接受过正颌手术或鼻整形手术的患者。分离类型分类如下：LNW类型；1型-起自截骨线；2型-在截骨线上方2-4mm；3型-在截骨线上方4mm或更多。PMJ类型；1型-包括上颌结节；2型-起自翼上颌连接部；3型-包括翼板。进行卡方检验以确定组与LNW分离类型、组与PMJ分离类型以及LNW分离类型与PMJ分离类型之间是否存在显著相关性。P值<0.05被认为具有统计学意义。
在传统组（P=0.052）和研究组（P=0.828）中，LNW深度之间均无显著差异。1型（P=0.0003）和2型（P=0.0051）LNW分离类型在组间存在显著差异。卡方检验显示手术组与PMJ分离模式之间存在显著相关性（P<0.05）。
定制化LNO优化了LNW和PMJ的分离。有助于Le Fort I型手术并减少PMJ的意外骨折。
