目的:通过裂隙进行SegmentalLeFortI截骨术是缩小成人肺泡裂隙的常用策略。这项研究比较了单侧唇腭裂(UCLP)患者单节段LeFortI截骨术之间的骨骼稳定性。
方法:这项回顾性分析检查了45名患有完全UCLP相关III类畸形的成年人,他们接受了单例(n=30)或节段(n=15)LeFortI进展的双颌手术。手术前采集面部骨骼的锥形束计算机断层扫描(CBCT)扫描,术后1周,在后续。比较两个治疗组的CBCT图像中的界标测量的平移(左/右,后/前,上/下)和旋转(偏航,roll,间距)。
结果:手术后,节段组上颌骨的向下运动大于单组。在后续行动中,两组上颌骨都向后移动,在分段组中向上。两组下颌骨向前和向上移动并向上旋转。分段组的向上运动和旋转量大于单组。
结论:在患有UCLP相关的III类畸形的患者进行双颌手术两年后,在上颌骨和下颌骨的垂直平移中,节段性LeFortI截骨术后发现了更大的复发,与单个LeFortI截骨术相比,下颌骨的俯仰旋转。
结论:与裂隙中的单个LeFortI推进相比,节段LeFortI推进后上颌骨的垂直复发更大。
OBJECTIVE: Segmental Le Fort I osteotomy through the cleft is a common strategy to narrow the alveolar cleft in adults. This study compared skeletal stability between single and segmental Le Fort I osteotomies in patients with unilateral cleft lip and palate (UCLP).
METHODS: This retrospective analysis examined 45 adults with complete UCLP-associated class III deformities who underwent bimaxillary surgery with either single (n = 30) or segmental (n = 15) Le Fort I advancement. Cone beam computed tomography (CBCT) scans of the facial skeleton were acquired before surgery, 1-week postsurgery, and at follow-up. Measures of landmarks from the CBCT images for the two treatment groups were compared for translation (left/right, posterior/anterior, superior/inferior) and rotation (yaw, roll, pitch).
RESULTS: Postsurgery, the downward movement of the maxilla was larger in the segmental group than the single group. At follow-up, the maxilla moved backward in both groups, and upward in the segmental group. The mandible moved forward and upward and rotated upward in both groups. The amount of upward movement and rotation was larger in the segmental group than the single group.
CONCLUSIONS: Two years after bimaxillary surgery in patients with UCLP-associated class III deformity, greater relapse was found after segmental Le Fort I osteotomies in vertical translation of the maxilla and mandible, and pitch rotation of the mandible compared with single Le Fort I osteotomies.
CONCLUSIONS: The vertical relapse of the maxilla was larger after segmental Le Fort I advancement compared with single Le Fort I advancement in clefts.