Evaluation of Lefort I Osteotomy Line and Pterygomaxillary Junction Region in Patients With Cleft Lip and Palate

2020 ◽  
pp. 105566562096957
Author(s):  
Bahadır Sancar ◽  
Şuayip Burak Duman
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Le Fort I Osteotomy ◽  
Maxillary Hypoplasia ◽  
Le Fort ◽  
Osteotomy Line ◽  
Le Fort I ◽  
Pterygomaxillary Junction

Objective: This study aimed to evaluate the Le Fort I osteotomy line and pterygomaxillary junction via cone-beam computed tomography in individuals with cleft lip and palate (CLP). Design: Retrospective study. Patients and Methods: The study included individuals older than 16 years with CLP, who were scheduled for repositioning of the maxilla by Le Fort I osteotomy, and those with class III malocclusion with maxillary hypoplasia, who were scheduled for Le Fort I osteotomy. The measurements made in the area of the cleft of individuals with CLP were compared with both the side with no cleft and those with class III malocclusion with maxillary hypoplasia. A total of 11 measurements were made on the axial section parallel to the Frankfurt Horizontal plane, corresponding to the lower 1/5 of the distance between the infraorbital foramen and the anterior nasal spine. Results: There were significant differences both in the comparisons made between the individuals with CLP and those without CLP in terms of the canal-anterior alveolar crest (G) and sinus-anterior alveolar crest (L) measurements ( P < .05). The mean measurement values showed that the measurement results were higher in individuals with CLP in general. Conclusion: In conclusion, we believe that there might be difficulties both in osteotomy and down fracture stages during Le Fort I osteotomies performed in individuals with CLP.

Morphologic Evaluation for Safe Le Fort I Osteotomy in Cleft Lip and Palate

2018 ◽  
Vol 55 (5) ◽  
pp. 728-735
Author(s):  
Miki Watanabe ◽  
Akira Watanabe ◽  
Nobuo Takano ◽  
Chikara Saito ◽  
Takahiko Shibahara
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Control Group ◽  
Bone Thickness ◽  
Le Fort I Osteotomy ◽  
Le Fort ◽  
Alveolar Bone Grafting ◽  
Le Fort I ◽  
Palatine Artery ◽  
Pterygomaxillary Junction

Objective: The present study aimed to determine the structure and morphology of the maxilla in patients with cleft lip and palate to ensure safe Le Fort I osteotomy. Patients: A total of 34 sides of 17 patients with unilateral cleft lip and palate (nonsyndromic cases) were included in this study. The control group included 10 sides of 5 patients who exhibited skeletal mandibular protrusion without malformation. Methods: Finite element analysis was performed to examine the distribution of occlusal force over the maxilla, and continuous 3-dimensional measurement was performed at the sites of stress concentration. Results: In patients with cleft lip and palate, bones at the lateral border of the piriform aperture and the anterior wall of the maxillary sinus were significantly thicker than those in controls ( P < .05). Furthermore, the attachment of the pterygomaxillary junction was wider and thicker ( P < .05), and the anterior distance to the descending palatine artery was shorter ( P < .01) in patients with cleft lip and palate than in controls. Our results further indicated that alveolar bone grafting may significantly influence bone thickness and the attachment state of the pterygomaxillary junction. Conclusions: Our results suggest that the complications of LFI can be reduced in patients with cleft lip and palate by ensuring proper understanding of each patient’s maxillary anatomy and bone thickness, as well as the location of the descending palatine artery and the attachment state of the pterygomaxillary junction.

Frequency of Le Fort I Osteotomy after Repaired Cleft Lip and Palate or Cleft Palate

2007 ◽  
Vol 44 (4) ◽  
pp. 396-401 ◽  
Author(s):  
Phoebe M. Good ◽  
John B. Mulliken ◽  
Bonnie L. Padwa
Keyword(s):  
Cohort Study ◽  
Cleft Palate ◽  
Retrospective Cohort ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Le Fort I Osteotomy ◽  
Chi Square ◽  
Maxillary Hypoplasia ◽  
Le Fort ◽  
Le Fort I

Objective: Diminished maxillary growth is a consequence of labiopalatal repair, and many patients with cleft lip and palate require Le Fort I advancement. The goal of this study was to determine the frequency of maxillary hypoplasia as measured by need for Le Fort I. Subjects: Retrospective cohort study of males born before 1987 and females before 1989. Records of 173 patients with cleft lip and palate and 34 with cleft palate were reviewed. Methods: Documented age, gender, cleft type, and need for Le Fort I. Pearson chi-square and Fischer's exact analyses were performed to evaluate the frequency of Le Fort I. Results: Of 217 patients with cleft lip and palate or cleft palate, 40 were syndromic; of the remaining 177 patients, 69 had cleft lip, 78 had cleft lip and palate, and 30 had cleft palate. Thirty-seven of 177 patients (20.9%) required Le Fort I, subcategorized by cleft type: 0/69 for cleft lip, 37/78 for cleft lip and palate, and 0/35 for cleft palate (p < .0001). Of the 37/78 (47.4%) cleft lip and palate patients, the frequency of Le Fort I correlated with severity: 5/22 unilateral incomplete cleft lip and palate; 16/33 unilateral complete cleft lip and palate; 1/2 bilateral incomplete cleft lip and palate; 2/4 bilateral asymmetric complete/incomplete cleft lip and palate; 13/17 bilateral complete cleft lip and palate (p < .05). Conclusion: Overall frequency of Le Fort I was 20.9% in patients with cleft lip and palate and cleft palate. Of those with cleft lip and palate, 47.7% required maxillary advancement, but none with isolated cleft lip or cleft palate required correction. Frequency of Le Fort I osteotomy correlated with the spectrum of severity of labiopalatal clefting.

Traumatic Arteriovenous Malformation following Maxillary Le Fort I Osteotomy

2008 ◽  
Vol 45 (3) ◽  
pp. 329-331 ◽  
Author(s):  
I. M. Smith ◽  
P. J. Anderson ◽  
M. J. Wilks ◽  
D. J. David
Keyword(s):  
Arteriovenous Malformation ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Rare Complication ◽  
Le Fort I Osteotomy ◽  
Le Fort ◽  
Le Fort I

Objective: Complications following maxillary Le Fort I osteotomy are rare. The authors present the rare complication of an arteriovenous malformation following such a procedure in a 25-year-old woman with a cleft lip and palate that was treated successfully with radiologically guided embolization.

scholarly journals A Case Report of Adult Unilateral Cleft Lip and Palate Treated with Closure of Wide Alveolar Cleft by le Fort I Osteotomy

2010 ◽  
Vol 20 (3) ◽  
pp. 258-265
Author(s):  
AYA HONDA ◽  
YOSHIYUKI BABA ◽  
KEIICHI KATAOKA ◽  
SHOICHI SUZUKI ◽  
KEIICHI MORITA ◽  
...  
Keyword(s):  
Case Report ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Le Fort I Osteotomy ◽  
Le Fort ◽  
Alveolar Cleft ◽  
Le Fort I
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