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Randomized Controlled Trial
. 2025 Mar 1;30(2):e297-e305.
doi: 10.4317/medoral.26939.

What is the impact of lateral nasal wall osteotomy depth on pterygomaxillary separation during a Le Fort I downfracture?

T Pergel  1 , E-F Akkoyun, G Kasarcioglu, D Dolanmaz
Affiliations
Randomized Controlled Trial

What is the impact of lateral nasal wall osteotomy depth on pterygomaxillary separation during a Le Fort I downfracture?

T Pergel et al. Med Oral Patol Oral Cir Bucal. .

Abstract

Background: 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.

Material and methods: 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.

Results: 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).

Conclusions: Customized LNO optimizes the LNW and PMJ separation. Facilitates the Le Fort I surgery and decrease unintentional fracture of the PMJ.

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Conflict of interest statement

The authors declare no conflict of interest. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

Figures

Figure 1
Figure 1
Assessment of the lateral nasal wall (LNW) separation type. The arrow on the left side shows a Type 2 LNW separation.
Figure 2
Figure 2
Lateral nasal wall (LNW) depth (B,C), pterygomaxillary junction (PMJ) thickness (D) and PMJ width (A) measurements in the axial CT section.
Figure 3
Figure 3
Distribution of lateral nasal wall (LNW) (A) and pterygomaxillary junction (PMJ) (B) separation patterns in the groups.
Figure 4
Figure 4
Distribution of pterygomaxillary junction (PMJ) separation patterns with respect to lateral nasal wall (LNW) separation patterns in the conventional group (A) and in the study group (B).
See this image and copyright information in PMC

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References

    1. Sakharia A, Muthusekar M. A comparative assessment of maxillary perfusion between two different Le Fort I osteotomy techniques. Int J Oral Maxillofac Surg. 2015;44:343–8. - PubMed
    1. Eshghpour M, Mianbandi V, Samieirad S. Intra- and Postoperative Complications of Le Fort I Maxillary Osteotomy. J Craniofac Surg. 2018;29:e797–803. - PubMed
    1. Li KK, Meara JG, Alexander Jr A. Location of the descending palatine artery in relation to the Le Fort I osteotomy. J Oral Maxillofac Surg. 1996;54:822–5. - PubMed
    1. van Otterloo JJdM, Tuinzing DB, Greebe RB, van der Kwast WA. Intra-and early postoperative complications of the Le Fort I osteotomy: a retrospective study on 410 cases. Journal of Cranio-Maxillofacial Surgery. 1991;19:217–22. - PubMed
    1. Tung T, Chen Y, Bendor-Samuel R. Surgical complications of the Le Fort I osteotomy--a retrospective review of 146 cases. Changgeng Yi Xue Za Zhi. 1995;18:102–7. - PubMed

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