PDF(Pubmed)
Abstract：
BACKGROUND: Nasal septum osteotomy is used for separating the nasal septum and maxilla during a Le Fort I osteotomy. If this osteotomy is applied too high or is tilted into the nasal cavity, the sphenoid sinus and various adjacent vital structures may be damaged, and serious bleeding, neurological complications, blindness or even death may occur. The aim of this study is to determine the safety margin of the nasal septum osteotomy for sphenoid sinus during the Le Fort I surgery in cleft lip and palate (CLP) patients.
METHODS: Twenty cleft lip and palate (the CLP group) and 20 healthy individuals (the control group) were included in this study. Three values (two lines and an angle) were measured by cone beam computed tomography (CBCT). The first line is the line passing through the junction of the spina nasalis anterior point and the lower point of the perpendicular lamina of the palatine bone. The undersired line is the line passing through the junction of the spina nasalis anterior point and the lower anterior border of the base of the sphenoid sinus. The osteotomy angle is the angle between these two lines.
RESULTS: In the control group; a surgical line of 44.11-61.14 mm (mean 51.91 ± 4.32), an undesired line of 52.48-69.58 mm (mean 59.14 ± 5.08) and an angle of 18.22-27.270 (mean 22.66 ± 2.55) were found, while in the CLP group, a surgical line of 34.53-51.16 mm (mean 43.38 ± 4.79), an undesired line of 46.86-61.35 mm (mean 55.02 ± 3.24) and an angle of 17.60-28.810 (mean 22.60 ± 2.81) were found.
CONCLUSIONS: Although the angle to the sphenoid sinus was not significantly affected by CLP, careful planning and consideration of these anatomical differences are crucial to prevent complications and ensure the safety of Le Fort I surgery in CLP patients. Further research with larger sample sizes and subgroup analysis of unilateral and bilateral CLP cases is needed to improve our understanding of these anatomical variations and improve surgical approaches to individuals with CLP undergoing orthognathic procedures.
METHODS: Twenty cleft lip and palate (the CLP group) and 20 healthy individuals (the control group) were included in this study. Three values (two lines and an angle) were measured by cone beam computed tomography (CBCT). The first line is the line passing through the junction of the spina nasalis anterior point and the lower point of the perpendicular lamina of the palatine bone. The undersired line is the line passing through the junction of the spina nasalis anterior point and the lower anterior border of the base of the sphenoid sinus. The osteotomy angle is the angle between these two lines.
RESULTS: In the control group; a surgical line of 44.11-61.14 mm (mean 51.91 ± 4.32), an undesired line of 52.48-69.58 mm (mean 59.14 ± 5.08) and an angle of 18.22-27.270 (mean 22.66 ± 2.55) were found, while in the CLP group, a surgical line of 34.53-51.16 mm (mean 43.38 ± 4.79), an undesired line of 46.86-61.35 mm (mean 55.02 ± 3.24) and an angle of 17.60-28.810 (mean 22.60 ± 2.81) were found.
CONCLUSIONS: Although the angle to the sphenoid sinus was not significantly affected by CLP, careful planning and consideration of these anatomical differences are crucial to prevent complications and ensure the safety of Le Fort I surgery in CLP patients. Further research with larger sample sizes and subgroup analysis of unilateral and bilateral CLP cases is needed to improve our understanding of these anatomical variations and improve surgical approaches to individuals with CLP undergoing orthognathic procedures.
摘要：
背景：鼻中隔截骨术用于在LeFortI截骨术中分离鼻中隔和上颌骨。如果截骨术应用得太高或倾斜到鼻腔中，蝶窦和邻近的各种重要结构可能受损，严重出血,神经系统并发症,可能会失明甚至死亡。这项研究的目的是确定唇腭裂（CLP）患者LeFortI手术期间蝶窦鼻中隔截骨术的安全范围。
方法：本研究包括20例唇腭裂（CLP组）和20例健康个体（对照组）。通过锥形束计算机断层扫描（CBCT）测量三个值（两条线和角度）。第一条线是穿过脊柱鼻前点和腭骨垂直椎板下部点的交界处的线。下划线是穿过脊柱鼻前点和蝶窦基部下前边界的交界处的线。截骨角度是这两条线之间的角度。
结果：在对照组中；手术线为44.11-61.14mm（平均51.91±4.32），发现一条不希望的线为52.48-69.58毫米（平均59.14±5.08）和角度为18.22-27.270（平均22.66±2.55），而在CLP组，手术线为34.53-51.16mm（平均43.38±4.79），发现一条46.86-61.35mm（平均55.02±3.24）的非期望线和17.60-28.810（平均22.60±2.81）的角度。
结论：尽管与蝶窦的角度没有受到CLP的显著影响，仔细计划和考虑这些解剖学差异对于预防并发症和确保CLP患者LeFortI手术的安全性至关重要.需要进一步研究更大的样本量和单侧和双侧CLP病例的亚组分析，以提高我们对这些解剖变异的理解，并改善接受正颌手术的CLP患者的手术方法。
方法：本研究包括20例唇腭裂（CLP组）和20例健康个体（对照组）。通过锥形束计算机断层扫描（CBCT）测量三个值（两条线和角度）。第一条线是穿过脊柱鼻前点和腭骨垂直椎板下部点的交界处的线。下划线是穿过脊柱鼻前点和蝶窦基部下前边界的交界处的线。截骨角度是这两条线之间的角度。
结果：在对照组中；手术线为44.11-61.14mm（平均51.91±4.32），发现一条不希望的线为52.48-69.58毫米（平均59.14±5.08）和角度为18.22-27.270（平均22.66±2.55），而在CLP组，手术线为34.53-51.16mm（平均43.38±4.79），发现一条46.86-61.35mm（平均55.02±3.24）的非期望线和17.60-28.810（平均22.60±2.81）的角度。
结论：尽管与蝶窦的角度没有受到CLP的显著影响，仔细计划和考虑这些解剖学差异对于预防并发症和确保CLP患者LeFortI手术的安全性至关重要.需要进一步研究更大的样本量和单侧和双侧CLP病例的亚组分析，以提高我们对这些解剖变异的理解，并改善接受正颌手术的CLP患者的手术方法。
