Comparison of the distance from the piriform rim to the descending palatine artery in lateral nasal osteotomy at the level of conventional LeFort I and high LeFort I osteotomy using cone-beam computed tomography in Thai
Article Sidebar
Main Article Content
Abstract
The objective of the study was to compare the distance from piriform rim to descending palatine artery at the level of conventional and high LeFort I osteotomy through CBCT in Thai. The distances from piriform rim to greater palatine canal in lateral nasal osteotomy at the level of conventional and high LeFort I osteotomy were measured through CBCT from 50 Thai patients and were divided into males versus females, right versus left. The comparisons of surgical levels and both sides of each patient were made using the paired t-test, whereas an unpaired t-test was used to compare between genders. Statistical significance was considered at p < 0.05. For the results, the mean distance at high LeFort I was 38.2 ± 2.20 mm (males; 39.2 ± 1.98 mm, females;36.9 ± 1.82 mm, right; 38.2 ± 2.18 mm, left; 38.2 ± 2.25). It showed significantly greater than the mean distance at conventional LeFort I, which was 34.1 ± 2.14 mm (males; 35.0 ± 1.97 mm, females;33.0 ± 1.85 mm, right; 34.3 ± 2.12 mm, left; 34.0 ± 2.17). For conclusions, the distance from piriform rim to descending palatine artery at high LeFort I level in Thai patients was significantly greater than LeFort I level. Suggesting that the lateral nasal osteotomy at high LeFort I level should be extended longer than conventional LeFort I level, to decrease complications. In addition, this distance was different regarding genders and also sides of individuals. It is crucial to identify the descending palatine artery’s exact location through CBCT before surgery.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The opinions and content expressed in the articles are solely those of the individual authors and do not necessarily reflect the views of the journal or the authors’ affiliated institutions. Authors are fully responsible for the accuracy and correctness of their work.
Any reuse, reproduction, or redistribution of the articles, content, data, or images in other forms requires prior written permission from the Thai Journal of Oral and Maxillofacial Surgery
References
Kawakami K, Yamanouchi Y, Matsumoto K, Sakai N, Kawamura Y, Matsumura H, et al.A new operative mode for sphenoclival regions; trans Le Fort I approach. No Shinkei Geka. 1992;20:333-8.
Moorhead A, Serra M. Le Fort osteotomy[Internet]. 2023 [cited 2024 Jun 20] Available from:https://www.ncbi.nlm.nih.gov/books/NBK564372
Roy S, Patel PK, Tomita T. The LeFort I transmaxillary approach to skull base tumors. Clin Plast Surg.2007;34: 575-83.
Scolozzi P, Imholz B. Completion of nonreducible Le Fort fractures by Le Fort I osteotomy:sometimes an inevitable choice to avoid postoperative malocclusion. J Craniofac Surg. 2015;26:59-61.
Suzen M, Temiz M, Cesur K, Uckan S. Safe Limits of lateral nasal wall osteotomy at Le Fort I surgery.ORL J Otorhinolaryngol Relat Spec. 2023;85:97-103.
Suzen M, Temiz M, Demirel O, Uckan S. Surgical protocol for a safe lateral nasal wall osteotomy.J Craniofac Surg. 2020;31:853-5.
Brennan PA, Schliephake H, Ghali GE, Cascarini L. Maxillofacial surgery. 3rd ed. St. Louis:Elsevier; 2017. p. 1158-9.
Lanigan DT, Hey JH, West RA. Major vascular complications of orthognathic surgery:hemorrhage associated with Le Fort I osteotomies. J Oral Maxillofac Surg. 1990;48:561-73.
Lanigan DT, West RA. Management of postoperative hemorrhage following the Le Fort I maxillary osteotomy.J Oral Maxillofac Surg. 1984;42:367-75.
Dadwal H, Shanmugasundaram S, Krishnakumar Raja VB. Preoperative and postoperative CT scan assessment of pterygomaxillary junction in patients undergoing Le Fort I osteotomy:comparison of pterygomaxillary dysjunction technique and trimble technique-a pilot study.
J Maxillofac Oral Surg. 2015;14:713-9.
Politis C. Life-threatening haemorrhage after 750 Le Fort I osteotomies and 376 SARPE procedures.Int J Oral Maxillofac Surg. 2012;41:702-8.
Kim YI, Park SB, Son WS, Hwang DS. Midfacial soft-tissue changes after advancement of maxilla with Le Fort I osteotomy and mandibular setback surgery: comparison of conventional and high Le Fort I osteotomies by superimposition of cone-beam computed tomography volumes. J Oral Maxillofac Surg. 2011;69:225-33.
Sugahara K, Koyachi M, Odaka K, Matsunaga S, Katakura A. A safe, stable, and convenient three-dimensional device for high Le Fort I osteotomy. Maxillofac Plast Reconstr Surg. 2020;42:32.
Júnior MAB, Cortez DLL, Bessa-Nogueira RV, Mikami JR. Modified quadrangular LeFort I osteotomy on a Crouzon Syndrome patient: a case report. J Dent Maxillofacial Res. 2021;4:18-22.
Li KK, Meara JG, Alexander AJ. Location of the descending palatine artery in relation to the Le Fort I osteotomy. J Oral Maxillofac Surg. 1996;54:822-7.
Bianchi A, Muyldermans L, Di Martino M, Lancellotti L, Amadori S, Sarti A, et al.Facial soft tissue esthetic predictions: validation in craniomaxillofacial surgery with cone beam computed tomography data. J Oral Maxillofac Surg. 2010;68:1471-9.
Khambay B, Nairn N, Bell A, Miller J, Bowman A, Ayoub AF. Validation and reproducibility of a high-resolution three-dimensional facial imaging system. Br J Oral Maxillofac Surg. 2008;46:27-32.
Fonseka MCN, Hettiarachchi P, Jayasinghe RM, Jayasinghe RD, Nanayakkara CD.A cone beam computed tomographic analysis of the greater palatine foramen in a cohort of SriLankans. J Oral Biol Craniofac Res. 2019;9:306-10.
Oliveira GQV, Rossi MA, Vasconcelos TV, Neves FS, Crusoé-Rebello I. Cone beam computed tomography assessment of the pterygomaxillary region and palatine canal for Le Fort I osteotomy. Int J Oral Maxillofac Surg. 2017;46:1017-23.
Naini FB, Gill DS. Orthognathic surgery: principles, planning and practice. Chichester:Wiley-Blackwell; 2017. p. 347-60.
Nelson RL, Path MG, Ogle RG, Waite DE, Meyer MW. Quantitation of blood flow after Le Fort I osteotomy.J Oral Surg. 1977;35:10-6.
Soriano RM, Das JM. Anatomy, head and neck, maxilla [Internet]. 2022 [cited 2024 Jun 20] Available from: https://www.ncbi.nlm.nih.gov/books/NBK538527
Epker BN. Vascular considerations in orthognathic surgery II. Maxillary osteotomies.Oral Surg Oral Med Oral Pathol. 1984;57:473-8.
Lanigan DT, Hey JH, West RA. Aseptic necrosis following maxillary osteotomies:report of 36 cases. J Oral Maxillo- fac Surg. 1990;48:142-56.
Parnes EI, Becker ML. Necrosis of the anterior maxilla following osteotomy.Oral Surg Oral Med Oral Pathol. 1972;33:326-30.
Westwood RM, Tilson HB. Complications associated with maxillary osteotomies. J Oral Surg. 1975;33:104-15.
Regan BO, Bharadwaj G. The identification and protection of the descending palatine artery in Le Fort I osteotomy: a forgotten technique? Br J Oral Maxillofac Surg. 2007; 45:412-4.
Apinhasmit W, Chompoopong S, Methathrathip D, Sangvichien S, Karuwanarint S.Clinical anatomy of the posterior maxilla pertaining to Le Fort I osteotomy in Thais. Clin Anat. 2005;18:323-9.