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Le Fort I osteotomy with sparing fracture of lateral pterygoid plate

 Kun Hwang  ;  Dae Kwang Lee  ;  In Hyuk Chung  ;  Se Il Lee 
 JOURNAL OF CRANIOFACIAL SURGERY, Vol.12(1) : 48-52, 2001 
Journal Title
Issue Date
Adult ; Aged ; Exostoses/surgery ; Humans ; Maxilla/anatomy & histology ; Maxilla/surgery ; Maxillary Diseases/surgery* ; Middle Aged ; Osteotomy, Le Fort/adverse effects ; Osteotomy, Le Fort/methods* ; Skull Fractures/etiology ; Skull Fractures/prevention & control* ; Sphenoid Bone/anatomy & histology ; Sphenoid Bone/injuries* ; Statistics, Nonparametric
Le Fort osteotomy ; fracture ; lateral pterygoid plate
This study aimed to clarify the relation between the anatomical variations of the pterygomaxillary region and fracture of the pterygoid plate during Le Fort I osteotomy. We present a secure method to separate maxillary tuberosities from pterygoid plates without injuring the pterygoid plates. Thirty specimens of hemisection of Korean skulls were used for the study. The maxilla was sectioned transversely on the floor of the pyriform aperture and posteriorly to the lateral pterygoid plate with a mechanical saw. The section was 5 to 6 mm above the tooth roots. The pterygomaxillary junction was separated with a curved osteotome in two steps: initially with light tapping of the shallow groove 2 to 3 mm anterior to the pterygomaxillary fissure at a half right angle and then changing the course of forceful tapping to more than 60 degrees. The maxillary tuberosity separated from the medial and lateral pterygoid plates during the procedure was grouped into the "disjunction group" (24 of 30, 80%) and the pterygoid plates fractured were grouped into the "fracture group" (6 of 30, 20%). The thickness of the pterygomaxillary region (T) was significantly greater in the disjunction group than in the fracture group (P = 0.034). The concavity of the pterygomaxillary fissure (C) was significantly deeper in the disjunction group than in the fracture group (P = 0.020). There was no significant difference of width of the pterygomaxillary fissure between the disjunction group and the fracture group (P = 0.169). The thin pterygomaxillary region and less concave pterygomaxillary fissure on the preoperative computed tomography scan draw precautionary attention to vulnerable pterygoid plates fractured in the procedure of Le Fort I osteotomy.
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1. College of Medicine (의과대학) > Dept. of Anatomy (해부학교실) > 1. Journal Papers
Yonsei Authors
Chung, In Hyuk(정인혁)
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