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Le Fort

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https://www.readbyqxmd.com/read/29320322/multidetector-ct-of-midfacial-fractures-classification-systems-principles-of-reduction-and-common-complications
#1
David Dreizin, Arthur J Nam, Silviu C Diaconu, Mark P Bernstein, Uttam K Bodanapally, Felipe Munera
The advent of titanium hardware, which provides firm three-dimensional positional control, and the exquisite bone detail afforded by multidetector computed tomography (CT) have spurred the evolution of subunit-specific midfacial fracture management principles. The structural, diagnostic, and therapeutic complexity of the individual midfacial subunits, including the nose, the naso-orbito-ethmoidal region, the internal orbits, the zygomaticomaxillary complex, and the maxillary occlusion-bearing segment, are not adequately reflected in the Le Fort classification system, which provides only a general framework and has become less relevant in contemporary practice...
January 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29315067/-soft-tissue-management-to-control-nasal-changes-after-le-fort-i-osteotomy
#2
Federico Hernández-Alfaro, Ariane Paredes de Sousa Gil, Orion Luiz Haas Junior, Jorge Masià-Gridilla, Adaia Valls-Ontañón, Raquel Guijarro-Martinez
INTRODUCTION: Adverse effects in the nasolabial region should be anticipated after Le Fort I osteotomy. Intraoperative factors such as the extent of surgical dissection, type of closure and perinasal soft tissue reconstruction seem to influence soft tissue response. Attempts to control these changes have been made over the years and several techniques have been proposed. MATERIALS AND METHODS: The authors present a minimally invasive alternative surgical technique to control alar base widening as well as lip shortening...
December 2017: L' Orthodontie Française
https://www.readbyqxmd.com/read/29304328/use-of-intraoperative-computed-tomography-in-craniomaxillofacial-trauma-surgery
#3
Karl Cuddy, Baber Khatib, R Bryan Bell, Allen Cheng, Ashish Patel, Melissa Amundson, Eric J Dierks
PURPOSE: The use of technology to aid in assessment, planning, and management of complex craniomaxillofacial injuries is increasingly common. Preoperative computed tomography (CT) evaluation is considered the standard of care, and intraoperative imaging is becoming increasingly accessible. Limited data exist regarding the implication of intraoperative CT on decision making in the management of all sites of facial fractures. The purposes of this study were to characterize the use of an intraoperative CT scanner for craniomaxillofacial surgery within our institution, to quantify the effect of intraoperative CT on surgical decision making, and to attempt to provide guidance on when to use this technology...
December 13, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29301675/postoperative-nausea-and-vomiting-after-oral-and-maxillofacial-surgery-a-prospective-study
#4
M Dobbeleir, J De Coster, W Coucke, C Politis
Postoperative nausea and vomiting (PONV) is one of the most unpleasant experiences after surgery. It reduces patient satisfaction and also increases hospital costs due to longer hospitalizations. The aim of this prospective study was to determine whether orthognathic surgery is associated with more PONV than less invasive maxillofacial surgery. Three hundred and eight patients aged 8-87 years who underwent maxillofacial surgery were included. The PONV score, based on the Apfel score, was calculated preoperatively...
January 1, 2018: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29291388/how-do-le-fort-type-fractures-present-in-a-pediatric-cohort
#5
Alexandra Macmillan, Joseph Lopez, J D Luck, Muhammad Faateh, Paul Manson, Amir H Dorafshar
PURPOSE: Le Fort-type fractures are very rare in children, and there is a paucity of literature presenting their frequency and characteristics. The purpose of this study was to determine the etiology, frequency, and fracture patterns of children with severe facial trauma associated with pterygoid plate fractures in a pediatric cohort. PATIENTS AND METHODS: We performed a retrospective cohort study of all children aged younger than 16 years with pterygoid plate and facial fractures who presented to our institute between 1990 and 2010...
December 8, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29285336/surgiplanner-a-new-method-for-one-step-oral-rehabilitation-of-severe-atrophic-maxilla
#6
A Busato, V Vismara, F Grecchi, E Grecchi, D Lauritano
The implant-prosthetic rehabilitation of edentulous upper jaws has always been complex for surgeons and dentists. The lack of bone in both vertical and horizontal dimension does not allow the correct insertion of dental implants. In addition, patients with edentulous upper and lower arch have a loss of vertical dimension of the face and an aged expression. Many surgical techniques have been proposed to increase the bone volume, height and thickness, such as the Le Fort I osteotomy, the bone grafts and the placement of dental implants...
July 2017: Oral & Implantology
https://www.readbyqxmd.com/read/29285335/treatment-of-severe-atrophic-maxilla-with-zygomatic-implants-a-case-series
#7
I Balan, M DI Girolamo, D Lauritano, F Carinci
Treatment of severe maxillary atrophy with implants has achieved important successes in recent years. The limit of implant insertion is related to inadequate bone quantity (i.e. height and width). Alveolar bone grafting, sinus lifting and major grafting via Le Fort I osteotomy have used in the past to restore bone volume prior of implant insertion. However successes do not always occur and a second stage surgery is necessary in most cases. Immediate loading cannot be performed in all grafted bone. In recent years a new treatment approach has been proposed by using zygomatic implants...
July 2017: Oral & Implantology
https://www.readbyqxmd.com/read/29215195/temporomandibular-joint-positional-change-accompanies-post-surgical-mandibular-relapse-a-long-term-retrospective-study-among-patients-who-underwent-mandibular-advancement
#8
M Z Miao, B Wang, D Wu, S Zhang, S Wong, O Shi, A Hu, L Mao, B Fang
OBJECTIVE: This study evaluated the relationship between follow-up temporomandibular joint positional change and mandibular stability among patients who had orthognathic and orthodontic treatment for a skeletal Class II malocclusion. METHODS: Thirty-seven patients who underwent 2-jaw surgery (Le Fort I osteotomy, bilateral sagittal split ramus osteotomy and genioplasty with rigid internal fixation) were included with an average follow-up length of 8.10 ± 2.06 years...
December 7, 2017: Orthodontics & Craniofacial Research
https://www.readbyqxmd.com/read/29203260/the-helsinki-face-transplantation-surgical-aspects-and-1-year-outcome
#9
Patrik Lassus, Andrew Lindford, Jyrki Vuola, Leif Bäck, Sinikka Suominen, Karri Mesimäki, Tommy Wilkman, Tuija Ylä-Kotola, Erkki Tukiainen, Hannu Kuokkanen, Jyrki Törnwall
BACKGROUND: Since 2005, at least 38 facial transplantations have been performed worldwide. We herein describe the surgical technique and 1-year clinical outcome in Finland's first face transplant case. METHODS: A 34-year-old male who had a severe facial deformity following ballistic trauma in 1999 underwent facial transplantation at the Helsinki University Hospital on 8th February 2016. Three-dimensional (3D) technology was used to manufacture donor and recipient patient-specific osteotomy guides and a donor face mask...
November 15, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29202264/is-augmentation-required-to-correct-malar-deficiency-with-maxillary-advancement
#10
Chad Petersen, Michael R Markiewicz, Michael Miloro
PURPOSE: Patients with maxillary hypoplasia also have malar deficiency; therefore, planning can include consideration for simultaneous malar augmentation. The purpose of this study was to compare pre- and postoperative profiles of patients who underwent Le Fort I advancement, with and without malar augmentation, to assess the subjective perception of changes in malar eminence projection. MATERIALS AND METHODS: Patients who had maxillary advancement and mandibular setback with and without malar augmentation were evaluated through a survey consisting of pre- and postoperative photographs that were assessed by professionals and laypersons, and a visual analog scale was used to assess the malar region...
November 14, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29188642/-evaluation-for-vertical-stability-after-various-orthognathic-surgical-treatment-plans-for-skeletal-class-%C3%A2-malocclusion-with-anterior-open-bite
#11
Liu Xianwen, Ai Weijian, Zhou Huixi, Li Yunfeng, Liu Shuguang
OBJECTIVE: To evaluate vertical stability after various orthognathic surgical treatment plans for skeletal class Ⅲ malocclusion with anterior openbite. METHODS: A retrospective multicenter cohort study was conducted to investigate vertical stability after various orthognathic surgical treatment plans for skeletal class Ⅲ malocclusion with anterior openbite. From 2010-2016, 122 patients from two domestic stomatological hospitals were included in our study. Patients were divided into four groups according to their treatment plans, namely, bilateral sagittal split ramus osteotomy (BSSRO), intraoral vertical ramus osteotomy (IVRO), BSSRO+Le Fort Ⅰ, and IVRO+Le Fort Ⅰ...
October 1, 2017: Hua Xi Kou Qiang Yi Xue za Zhi, Huaxi Kouqiang Yixue Zazhi, West China Journal of Stomatology
https://www.readbyqxmd.com/read/29177168/le-fort-fractures-a-collective-review
#12
REVIEW
Bradley J Phillips, Lauren M Turco
Le Fort fractures constitute a pattern of complex facial injury that occurs secondary to blunt facial trauma.  The most common mechanisms of injury for these fractures, which are frequently associated with drug and alcohol use, include motor vehicle collisions, assault, and falls. A thorough search of the world's literature following PRISMA guidelines was conducted through PubMed and EBSCO databases. Search terms included "Le Fort fracture", "facial", "craniofacial", and "intracranial."  Articles were selected based on relevance and examined regarding etiology, epidemiology, diagnosis, treatment, complications, and outcomes in adults...
October 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/29135728/internal-distraction-resulted-in-improved-patient-reported-outcomes-for-midface-hypoplasia
#13
David I Hindin, Corbin E Muetterties, Justine C Lee, Anand Kumar, Henry K Kawamoto, James P Bradley
BACKGROUND: Both internal and external distraction devices have been used successfully in correcting midface hypoplasia. Although the indication for surgery and the osteotomy techniques may be similar, deciding when to use internal versus external devices has not been studied. The authors studied patient-reported outcomes with FACE-Q and functional surveys for internal and external devices for midface distraction patients. METHODS: Patients who underwent distraction advancement after Le Fort I and Le Fort III were surveyed using the FACE-Q survey and a functional survey...
November 9, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29109845/le-fort-i-type-osteotomy-retractor
#14
REVIEW
Maurice Yves Mommaerts
A new instrument for retracting the maxilla after mobilization is described. It does neither compress nor inadvertently pierce the lower lip and it does neither obliterate the view nor hinder access to bone removing instruments.
December 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/29108917/subcranial-and-orthognathic-surgery-for-obstructive-sleep-apnea-in-achondroplasia
#15
Srinivas M Susarla, Gerhard S Mundinger, Hitesh Kapadia, Mark Fisher, James Smartt, Christopher Derderian, Amir Dorafshar, Richard A Hopper
PURPOSE: Obstructive sleep apnea (OSA) is a common problem in patients with achondroplasia. The purpose of this study was to assess changes in airway volumes following various degrees of facial skeletal advancement. METHODS: This was a retrospective evaluation of patients with achondroplasia who underwent facial skeletal advancement for obstructive sleep apnea. Patients were treated with either an isolated Le Fort III distraction (LF3) or Le Fort II distraction with or without subsequent Le Fort I and bilateral sagittal split osteotomies (LF2 ± LF1/BSSO)...
October 5, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29108846/predictors-of-pediatric-blunt-cerebrovascular-injury
#16
Avery C Rossidis, Sasha J Tharakan, Sourav K Bose, Karuna V Shekdar, Michael L Nance, Thane A Blinman
BACKGROUND/PURPOSE: Blunt cerebrovascular injury (BCVI) is clinically challenging because these injuries are hard to detect and can have serious neurological consequences, and optimal screening criteria have not been established for children. This study aims to determine risk factors for BCVI in pediatric patients and to evaluate screening practices in a single institutional series. METHODS: A retrospective review of all pediatric blunt trauma patients evaluated over a 10-year period was performed...
October 12, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29104028/effectiveness-of-immersive-virtual-reality-in-surgical-training-a-randomized-control-trial
#17
Yeshwanth Pulijala, Minhua Ma, Matthew Pears, David Peebles, Ashraf Ayoub
PURPOSE: Surgical training methods are evolving with the technological advancements, including the application of virtual reality (VR) and augmented reality. However, 28 to 40% of novice residents are not confident in performing a major surgical procedure. VR surgery, an immersive VR (iVR) experience, was developed using Oculus Rift and Leap Motion devices (Leap Motion, Inc, San Francisco, CA) to address this challenge. Our iVR is a multisensory, holistic surgical training application that demonstrates a maxillofacial surgical technique, the Le Fort I osteotomy...
October 13, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29103825/is-subcranial-le-fort-iii-plus-le-fort-i-osteotomy-stable
#18
Fernanda Brasil Daura Jorge Boos Lima, Eduardo Hochuli Vieira, Philipp Juergens, Sergio Monteiro Lima Junior
The purpose of this study was to test whether associated subcranial Le Fort III (sLF III) and Le Fort I (LF I) osteotomies are stable after large advancements of the middle third of the face and maxilla. The authors designed a retrospective study and enrolled a sample of consecutive patients with midface hypoplasia treated with associated sLF III and LF I osteotomies in this IRB-approved study between September 2013 and February 2015. To test whether the long-term stability was satisfactory, the authors compared cephalometric changes from immediately after surgery to 18 months after surgery taken from multi-slice computed tomography using two different third-party imaging software programs...
October 3, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29102561/reaching-the-vertical-versus-horizontal-target-position-in-multi-segmental-le-fort-i-osteotomy-is-more-difficult-but-yields-comparably-stable-results-to-one-segment-osteotomy
#19
J Meewis, D Govaerts, B Falter, K Grisar, E Shaheen, G Van de Vyvere, C Politis
This retrospective cohort study evaluated the postoperative outcomes of preoperatively planned positional changes for Le Fort I osteotomy in 77 patients (average age 26.6 years). Movement relapse and planning accuracy were evaluated by lateral cephalometric analysis, with an average follow-up of 257 days. In one-segment osteotomy cases, 73% of the horizontal movements were positioned within 2mm of the surgical plan. With posterior-inferior repositioning of the maxilla, results fell within 2mm of the prescribed plan in 60% of cases...
November 1, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29084117/a-review-of-randomized-controlled-trials-in-cleft-and-craniofacial-surgery
#20
Jonathan M Bekisz, Elise Fryml, Roberto L Flores
This study presents a systematic review of randomized controlled trials (RCTs) in cleft and craniofacial surgery. All studies reporting on RCTs in cleft and craniofacial surgery were identified on PubMed using the search terms "cleft," "velopharyngeal insufficiency," "velopharyngeal dysfunction," "nasoalveolar molding," "gingivoperiosteoplasty," "Pierre Robin sequence," "craniofacial," "craniosynostosis," "craniofacial microsomia," "hemifacial microsomia," "hypertelorism," "Le Fort," "monobloc," "distraction osteogenesis," "Treacher Collins," and "Goldenhar...
October 27, 2017: Journal of Craniofacial Surgery
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