Sakai Y, Kobayashi S, Sekiguchi J, Ohmori K
Department of Plastic and Reconstructive Surgery, Tokyo Metropolitan Police Hospital, Japan.
J Craniofac Surg. 1996 Mar;7(2):111-6. doi: 10.1097/00001665-199603000-00006.
Endoscopic pterygomaxillary (PM) disjunction in a Le Fort type I osteotomy is presented, and the versatility of this new technique is discussed on the basis of our own experience. We have reexamined the anatomy of the posterior part of the maxilla, focusing in particular on the neurovascular bundle, to attempt to perform the endoscopic PM disjunction through the maxillary sinus along a new osteotomy line. We found that the use of an endoscope provided a magnified field of vision and a view of the objects being manipulated on a television monitor, thereby reducing the necessity of working blind. We have applied this technique in 10 clinical cases, and in all cases the Le Fort type I osteotomy was accomplished safely and with minimal bleeding. The operative time using an endoscope was about 15 minutes to 20 minutes on each side, and the blood loss during this manipulation was less than 50 mL. The application of the endoscope should widen in craniofacial surgical field when its advantages are recognized and new operative approaches for using it are developed.
本文介绍了在Le Fort I型截骨术中进行内镜下翼上颌（PM）分离术，并根据我们自己的经验讨论了这项新技术的多功能性。我们重新审视了上颌骨后部的解剖结构，尤其关注神经血管束，试图沿着一条新的截骨线通过上颌窦进行内镜下PM分离术。我们发现，使用内镜可提供放大的视野，并能在电视监视器上看到正在操作的物体，从而减少了盲目操作的必要性。我们已将这项技术应用于10例临床病例，所有病例均安全完成了Le Fort I型截骨术，且出血极少。使用内镜时，每侧的手术时间约为15分钟至20分钟，在此操作过程中的失血量少于50毫升。当内镜的优势得到认可并开发出使用它的新手术方法时，其在颅面外科领域的应用应该会得到拓展。
