Long-Term Results after Maxillary Advancement in Patients with Clefts

1993 ◽  
Vol 30 (2) ◽  
pp. 237-243 ◽  
Author(s):  
Walter Hochban ◽  
Carolina Ganß ◽  
Karl Heinz Austermann
Keyword(s):  
Clinical Examination ◽  
Long Term Results ◽  
Le Fort I Osteotomy ◽  
Le Fort ◽  
Maxillary Advancement ◽  
Le Fort I ◽  
Maxillary Deficiency ◽  
Mandibular Surgery

In order to evaluate relapse tendencies after maxillary advancement, 31 patients were examined preoperatively, postoperatively, and 1 year postoperatively; 14 of whom had clefts of the lip, alveolus, and palate. Patients with maxillary deficiency were selected in a method that mere sagittal displacement was planned. Any patients with major vertical or transverse changes or additional mandibular surgery were excluded. Treatment consisted of maxillary advancement by Le Fort I osteotomy and miniplate fixation. Besides clinical examination, skeletal and dental changes were assessed cephalometrically. Results revealed a certain relapse tendency of the displacement in the noncleft group that compared favorably to the cleft group. This relapse is dependent on the amount of advancement. Despite minor differences, the two groups did not differ significantly based on maxillary advancement, so besides advancement surgery there must be another factor, cleft, to explain the different relapse tendencies between patients with and without clefts.

Middle and Lower Facial Soft Tissue Changes after Maxillary Advancement through Conventional or High Le Fort I Osteotomy: A Case Series Study

2019 ◽  
Author(s):  
Ramin Foroughi ◽  
Oveis Khakbaz ◽  
Mehrdad Maneshi
Keyword(s):  
Case Series ◽  
Mean Difference ◽  
Class Iii ◽  
Le Fort I Osteotomy ◽  
Le Fort ◽  
Maxillary Advancement ◽  
Tissue Changes ◽  
Group 2 ◽  
Le Fort I ◽  
Group 1

Introduction Maxillary advancementis applied extensively for malocclusion class III correction.This procedure is done using one of the two methods, Conventional or High. Maxilla moves in both vertical and horizontal and only in the horizontal directions in Conventional and High method respectively, so expecting a difference in facialsoft tissue changes. In present study is a case series that describes this issue. Materials and Methods: The cases included 30 patients with class III malocclusion due to maxillary deficiency, whom underwent Le Fort I osteotomy for maxillary advancement in Shahid Beheshti Hospital in Babol, Iran during 1995 to 1995. According to surgical technique, the cases were placed in group 1 (Conventional) or group 2 (High). Maxillary advancement and changes in hard and soft tissue of the middle and lower facial regions where measured through tracing on the lateral cephalometry. Intra-group and inter-group statistical comparisons were done using SPSS20 software at significance level as 0.05. Result: The pre-surgical mean size of SNA, SNB, nasolabial and mentolabial angles was similar in two groups. In all patients, after surgery, SNA angle size was increased and SNB، nasolabial and Mentolabial angles size were decreased. The mean value of these change was similar in two groups. In group 2, the displacement of point A ‘(mean difference: 1.30 mm) and Labrale Superius (mean difference: 1.40 mm) were significantly more than group 1. The amount of displacement of SN (mean difference: 1.30 mm), Labrale Inferius (mean difference: 0.88 mm) and Pogonion (mean difference: 0.23 mm) points in group 2 was higher than that of group 1, but this difference was not statistically significant. Conclusion: It is needed strong evidence for decision about selecting High or Conventional approach maxillary advancement in terms of facial aesthetic aspects. So, further studies with larger sample sizes and cohort or quasi-experimental design is suggested

scholarly journals Long-term Use of Le Fort I Osteotomy for the Management of Nasopharyngeal Rhinosporidiosis: A Case Series

2018 ◽  
Vol 97 (10-11) ◽  
pp. E36-E43
Author(s):  
Vikram Shetty ◽  
Akshaya Kulkarni ◽  
Suman Banerjee
Keyword(s):  
Nasal Mucosa ◽  
Treatment Protocol ◽  
Case Series ◽  
Le Fort I Osteotomy ◽  
Complete Excision ◽  
Le Fort ◽  
Long Term Follow Up ◽  
Le Fort I

Rhinosporidiosis is a rare, chronic, granulomatous infection of the mucous membranes that mainly involves the nose and nasopharynx; it occasionally involves the pharynx, conjunctiva, larynx, trachea and, rarely, the skin. The characteristic clinical features of this disease include the formation of painless polyps in the nasal mucosa or the nasopharynx that bleed easily on touch. At our center, excision of the lesion with a Le Fort I osteotomy is carried out in patients (1) in whom two or more previous attempts at excision of biopsy-proven rhinosporidiosis arising from the nasal mucosa was carried out or (2) in whom the rhinosporidiosis arises from the nasophayrngeal mucosa and/or extranasal sites. In this article we retrospectively present 7 cases in which, according to our inclusion criteria, complete excision of the lesion was carried out with a Le Fort I osteotomy. Excellent visualization of the entire maxillary and ethmoidal air cells after the down-fracture of the maxilla helped in the total removal of the lesions. Most of these lesions had multiple points of origin through the nasal, maxillary, and ethmoidal mucosa; the excellent visualization enabled direct cauterization of all these points of origin. The mean follow-up period was 7.96 years, and all patients were disease-free by the time the study was prepared. This article presents details of the treatment protocol and technique followed at our center for the treatment of nasopharyngeal rhinosporidiosis and the details of long-term follow-up. Through this study we hope to prove the efficacy of Le Fort I osteotomy in the definitive management of nasopharyngeal rhinosporidiosis.

scholarly journals Le Fort I osteotomy in cleft patients: Maxillary advancement and velopharyngeal function

2019 ◽  
Vol 47 (12) ◽  
pp. 1868-1874
Author(s):  
Roni Harjunpää ◽  
Suvi Alaluusua ◽  
Junnu Leikola ◽  
Arja Heliövaara
Keyword(s):  
Le Fort I Osteotomy ◽  
Le Fort ◽  
Maxillary Advancement ◽  
Velopharyngeal Function ◽  
Le Fort I
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