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Le Fort

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https://www.readbyqxmd.com/read/28106695/velopharyngeal-insufficiency-after-le-fort-i-osteotomy-in-a-patient-with-undiagnosed-occult-submucous-cleft-palate
#1
Rushil R Dang, Bonnie L Padwa, Cory M Resnick
The authors present a 16-year-old patient with no known history of cleft palate who developed velopharyngeal insufficiency after a Le Fort I osteotomy performed for the correction of maxillary hypoplasia and a Class III malocclusion. Postoperative evaluation revealed the presence of velopharyngeal insufficiency and subtle findings of an occult submucous cleft palate. She had a pharyngeal flap 6 months later with successful correction of the velopharyngeal insufficiency. This case illustrates the need to screen for submucous cleft palate prior to orthognathic surgery...
January 18, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28089389/three-dimensional-finite-element-model-to-predict-patterns-of-pterygomaxillary-dysjunction-during-le-fort-i-osteotomy
#2
H Fujii, N Kuroyanagi, T Kanazawa, S Yamamoto, H Miyachi, K Shimozato
The aim of this study was to determine whether non-linear three-dimensional finite element analysis (3D-FEA) can be applied to simulate pterygomaxillary dysjunction during Le Fort I osteotomy (LFI) not involving a curved osteotome (LFI-non-COSep), and to predict potential changes in the fracture pattern associated with extending the cutting line. Computed tomography (CT) image data (100 snapshots) after LFI were converted to 3D-CT images. 3D-FEA models were built using preoperative CT matrix data and used to simulate pterygomaxillary dysjunction...
January 12, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28063531/traitements-visant-la-vessie-hyperactive-accent-sur-la-pharmacoth%C3%A3-rapie
#3
Roxana Geoffrion
OBJECTIF: Offrir des lignes directrices en matière de pharmacothérapie pour la prise en charge du syndrome de la vessie hyperactive (VHA). OPTIONS: Parmi les agents pharmacothérapeutiques permettant la prise en charge du VHA, on trouve les anticholinergiques (antimuscariniques) et les œstrogènes administrés par voie vaginale. Des préparations anticholinergiques orales et transdermiques sont disponibles. ISSUES: Fournir une compréhension des données actuellement disponibles au sujet de l'innocuité et de l'efficacité clinique de la pharmacothérapie dans la prise en charge du VHA; orienter la sélection du traitement anticholinergique en fonction des caractéristiques personnelles des patientes...
December 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28060091/midface-distraction-osteogenesis-using-a-modified-external-device-with-elastic-distraction-for-crouzon-syndrome
#4
Haizhou Tong, Lei Liu, Xiaojun Tang, Tao Song, Ningbei Yin, Zhiyong Zhang, Zhenmin Zhao
PURPOSE: Midface distraction osteogenesis has been popularized for the correction of midface hypoplasia associated with exophthalmos and obstructive sleep apnea in patients with Crouzon syndrome. The purpose of this study was to present the method of utilizing the modified external device with elastic distraction for the midface advancement in Crouzon syndrome, and the clinical outcomes and skeletal changes were analyzed. METHODS: Five consecutive patients with Crouzon syndrome underwent Le Fort III osteotomy with midface advancement using a modified external device with elastic distraction...
January 5, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28049608/electromagnetic-navigated-positioning-of-the-maxilla-after-le-fort-i-osteotomy-in-preclinical-orthognathic-surgery-cases
#5
Moritz Berger, Igor Nova, Sebastian Kallus, Oliver Ristow, Urs Eisenmann, Christian Freudlsperger, Robin Seeberger, Jürgen Hoffmann, Hartmut Dickhaus
OBJECTIVES: Inaccuracies in orthognathic surgery can be caused during face-bow registration, model surgery on plaster models, and intermaxillary splint manufacturing. Electromagnetic (EM) navigation is a promising method for splintless digitized maxillary positioning. STUDY DESIGN: After performing Le Fort I osteotomy on 10 plastic skulls, the target position of the maxilla was guided by an EM navigation system. Specially implemented software illustrated the target position by real-time multistage colored three-dimensional imaging...
October 14, 2016: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/28045827/bone-substitutes-in-le-fort-i-osteotomy-to-promote-bone-union-and-skeletal-stability
#6
Leonardo Matos Santolim Zanettini, Guilherme Genehr Fritscher, Ricardo Giacomini De Marco, Fernando de Oliveira Andriola, Rogério Miranda Pagnoncelli
Maxillary advancement by Le Fort I osteotomy has become the standard procedure to restore function and facial esthetics, correct skeletal and occlusal discrepancies, and treat obstructive sleep apnea in patients with facial deformities. Incomplete ossification between the bone segments at the jaw osteotomy site has proven to be a major problem in these patients. There are several studies in the literature that address orthognathic surgery, but only a limited number that discuss the use of graft materials in maxillary osteotomy...
December 30, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28027171/measurement-of-distraction-force-in-cleft-lip-and-palate-patients-during-le-fort-i-maxillary-advancement-with-rigid-external-distraction
#7
Hiromi Sawada, Takuya Ogawa, Keiichi Kataoka, Yoshiyuki Baba, Keiji Moriyama
OBJECTIVE: Maxillary distraction osteogenesis (DO) is a mainstream surgical technique for patients who have severe maxillary hypoplasia associated with craniofacial syndromes and cleft-related deformities. However, limited information about the biomechanical aspects of maxillary DO is available limiting broad utilization and improvements to the procedure. The objective of this study was to analyze force levels during the active distraction process and to investigate the relationship between distraction force and maxillary movement during Le Fort I maxillary DO using a rigid external distraction (RED) system...
December 23, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28005730/correction-of-a-long-face-simultaneous-reduction-of-the-upper-lip-using-a-modified-endonasal-technique-and-le-fort-i-osteotomy-superior-impaction
#8
Seungil Chung, Sanghoon Park
BACKGROUND: Although Le Fort I osteotomy superior impaction during bimaxillary surgery is beneficial for patients with a long face, achieving satisfactory results can be challenging due to the redundant upper lip. However, upper-lip reduction has rarely been performed during or following bimaxillary surgery because of the difficulty in estimating the required amount of cutaneous resection needed and the apparent horizontal scars left behind. Therefore, no simultaneous cutaneous upper-lip reduction with orthognathic surgery has been reported...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28005656/skeletal-changes-of-an-osteomyocutaneous-facial-allograft-five-years-following-transplantation
#9
Bahar Bassiri Gharb, Antonio Rampazzo, Gaby Doumit, Steven Bernard, Maria Siemionow, Francis Papay, Risal Djohan
BACKGROUND: More than 30 face transplantations have been performed worldwide, most including part of the facial skeletal framework. In this study, the modifications of the skeletal component of a facial allograft were evaluated. METHODS: Standard head computed tomography (CT) scans, CT angiogram, and bone mineral densitometry were evaluated. Cephalometric analysis was performed. The pre and postoperative CT images were overlapped and the skeletal changes were expressed in a numeric and color-coded scale...
December 21, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27997450/acellular-dermal-matrix-as-an-adjunct-material-in-cleft-le-fort-i-osteotomies
#10
Srinivas M Susarla, Zoe M MacIsaac, Edward Swanson, Edward Davidson, Anand Kumar
PURPOSE: To evaluate the use of acellular dermal matrix in the management of nasal lining deficiency at the time of Le Fort I osteotomy. METHODS: This was a retrospective cohort study of patients with residual/recurrent oronasal fistulae who underwent Le Fort I osteotomy. In instances where there was an inadequate volume of nasal mucosa for tension-free closure or for defects >1 cm in width, the acellular dermal matrix was used for augmentation. Demographic and cleft-related factors were recorded...
December 16, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27986471/retrospective-clinical-study-of-maxillary-sagittal-fractures-predictors-of-postoperative-outcome
#11
Krishna Prasad Regmi, JunBo Tu, SuMeng Ge, ChengQun Hou, XiaoYi Hu, ShiXian Li, JingTing Du
PURPOSE: Because of less attention to the sagittal component of maxillary fractures, these fractures are often misdiagnosed and the reduction leading to maxillary transverse discrepancies is missed. Therefore, the purpose of this study was to identify factors associated with good or adverse postoperative outcomes of maxillary sagittal fractures. MATERIALS AND METHODS: This study was a single-center retrospective cohort study. The sample was composed of cases of maxillary sagittal fractures treated at the Department of Oral and Maxillofacial Surgery, Craniomaxillofacial Trauma Unit of Xi'an Jiaotong University (Xi'an, China) from January 2008 through December 2013...
November 23, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27977828/modified-lip-repositioning-with-esthetic-crown-lengthening-a-combined-approach-to-treating-excessive-gingival-display
#12
Isis M Sánchez, Sadja Gaud-Quintana, Jacob K Stern
Lip repositioning surgery to address excessive gingival display induced by different etiologies has received major attention recently. Several techniques and variations have been reported, including myotomy or repositioning of the levator labii superioris muscle, Le Fort impaction, maxillary gingivectomies, botulinum toxin injections, and lip stabilization. This study reports a case of excessive gingival display treated by a modified combined approach. A 25-year-old woman with a 4- to 8-mm gingival display when smiling caused by a combination of short clinical crowns induced by an altered passive eruption and hypermobility of the upper lip underwent a staged esthetic crown-lengthening procedure followed by a modified lip repositioning technique...
January 2017: International Journal of Periodontics & Restorative Dentistry
https://www.readbyqxmd.com/read/27975021/a-novel-technique-that-protects-the-lips-during-orthognathic-surgery
#13
Hideaki Kamochi, Yasushi Sugawara, Hirokazu Uda, Shunji Sarukawa, Ataru Sunaga, Kotaro Yoshimura
Serious lip injuries can occur during orthognathic surgery. Although an Angle Wider device, which is commonly used during orthognathic surgery, provides some lip protection, it leaves more than half of the lip exposed to surgical instruments. Here, we describe a novel technique to protect the entire upper and lower lips during orthognathic surgery using a minilaparotomy wound edge protector (Lap-Protector). We used this method in 60 patients who have undergone orthognathic surgeries such as sagittal split ramus osteotomy and Le Fort I osteotomy since 2009, and no lip injuries have occurred...
November 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27956141/slotplates-revisited-a-retrospective-analysis
#14
Brandaan G R Zigterman, Maurice Y Mommaerts
CONTEXT: Slotplates were specifically designed to meet the special requirements of corrective surgeries of the facial skeleton. This design enables small readjustments of bone fragments in the midface and chin area during surgery without complete removal of plates and screws. OBJECTIVE, DESIGN, AND SETTING: The aim of this study was to compare morbidity rates of slotplates versus meshplates after Le Fort I osteotomy, genioplasty and/or zygoma 'sandwich' osteotomy performed in a tertiary care centre...
November 2, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/27942547/evaluation-of-condylar-position-after-orthognathic-surgery-for-treatment-of-class-ii-vertical-maxillary-excess-and-mandibular-deficiency-by-using-cone-beam-computed-tomography
#15
Reza Tabrizi, Shoaleh Shahidi, Emad Bahramnejad, Hamidreza Arabion
STATEMENT OF THE PROBLEM: In orthognathic surgeries, proper condylar position is one of the most important factors in postoperative stability. Knowing the condylar movement after orthognathic surgery can help preventing postoperative instabilities. PURPOSE: The aim of this study was to evaluate the condylar positional changes after Le Fort I maxillary superior repositioning along with mandibular advancement by using cone beam computed tomography (CBCT). MATERIALS AND METHOD: This cross-sectional study was conducted on 22 subjects who had class II skeletal malocclusion along with vertical maxillary excess...
December 2016: Journal of Dentistry
https://www.readbyqxmd.com/read/27930464/nasal-airway-evaluation-after-le-fort-i-osteotomy-combined-with-septoplasty-in-patients-with-cleft-lip-and-palate
#16
Zhongying Wang, Peihua Wang, Yixin Zhang, Guofang Shen
Septal deviation constitutes an important component of both esthetic deformity and airway compromise in patients with cleft lip and palate (CLP). The posterior parts of the nasal septum presented greater deviation than the anterior parts in patients with complete unilateral CLP. Le Fort I down-fracture provides better access to the nasal septum than intranasal incision during rhinoplasty, especially to the posterior part. This study objectively and subjectively evaluated the nasal function after Le Fort I osteotomy combined with septoplasty in patients with complete unilateral CLP...
December 7, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27922963/publication-trends-in-craniofacial-distraction-a-bibliometrical-analysis
#17
Asra Hashmi, Adam Schumaier, Shenita White, Christina Yi, Faraz A Khan, Curtis J Hanba, Faisal Al-Mufarrej
PURPOSE: The purpose of this study was to analyze the craniofacial distraction literature published over the last 50 years and to determine various trends in publications. METHODS: A literature search was conducted in November and December 2015. The date search range was 1965 to 2015. Databases searched included Medline, Web of Science, Biosis, SciELO, Data Citation, and Zoologic Records. Data were collected on distraction type, author specialty, date of publication, country, state (if United States), number of citations, journal name, journal type, and Le Fort type (for midfacial distractions)...
December 5, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27922954/midface-advancement-in-a-simple-approach
#18
Herman Vercruysse, Ramon Sieira-Gil, Alfons Navarro, Eloy Garcia-Diez
BACKGROUND: Midface advancement is a keystone intervention in the treatment plan of syndromic hypoplasia of the midface. Although earlier authors had been using a combination of smaller incisions to acquire enough access to perform the different osteotomies, Tessier popularized the bicoronal incision. This approach can be time-consuming however and leaves an ear-to-ear scar. The authors describe an endoscopically assisted piezo-electric Le Fort III osteotomy performed through minimal invasive access...
December 5, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27896214/a-case-of-severe-mandibular-retrognathism-with-bilateral-condylar-deformities-treated-with-le-fort-i-osteotomy-and-two-advancement-genioplasty-procedures
#19
Masahiro Nakamura, Takeshi Yanagita, Tatsushi Matsumura, Takashi Yamashiro, Seiji Iida, Hiroshi Kamioka
We report a case involving a young female patient with severe mandibular retrognathism accompanied by mandibular condylar deformity that was effectively treated with Le Fort I osteotomy and two genioplasty procedures. At 9 years and 9 months of age, she was diagnosed with Angle Class III malocclusion, a skeletal Class II jaw relationship, an anterior crossbite, congenital absence of some teeth, and a left-sided cleft lip and palate. Although the anterior crossbite and narrow maxillary arch were corrected by interceptive orthodontic treatment, severe mandibular hypogrowth resulted in unexpectedly severe mandibular retrognathism after growth completion...
November 2016: Korean Journal of Orthodontics
https://www.readbyqxmd.com/read/27895942/an-unusual-lacerated-tracheal-tube-during-le-fort-surgery-literature-review-and-case-report
#20
Preeta George, John E Fiadjoe, Allan F Simpao
Maxillofacial surgeries can present unique anesthetic challenges due to potentially complex anatomy and the close proximity of the patient's airway to the surgical field. Damage to the tracheal tube (TT) during maxillofacial surgery may lead to significant airway compromise. We report the management of a patient with a partially severed TT during Le Fort surgery for midfacial hypoplasia and management strategies based on peer-reviewed literature. This case illustrates the clinical clues associated with a damaged TT and explores the challenges of managing this potentially catastrophic issue...
2016: Case Reports in Anesthesiology
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