• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권2호
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• pp.97-101
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• 2015

Maxillary transverse deficiency is one of the most common deformities among occlusal discrepancies. Typical surgical methods are segmental Le Fort I osteotomy and surgically-assisted rapid maxillary expansion (SARME). This patient underwent a parasagittal split with a Le Fort I osteotomy to correct transverse maxillary deficiency. During follow-up, early transverse relapse occurred and rapid maxillary expansion (RME) application with removal of the fixative plate on the constricted side was able to regain the dimension again. RME application may be appropriate salvage therapy for such a case.

• 대한치과교정학회지
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• 제26권5호
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• pp.637-645
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• 1996

성장이 완료된 골격성 III급 부정교합의 치료는 골격 부조화의 심도, 절치 치축, overbite와 연조직 측모의 심미성 등을 고려하여 필요한 경우 교정치료와 악교정수술을 병행하여 골격과 치아관계 개선에 따른 기능의 증진외에도 안모의 심미성을 증진시킬 수 있다. 특히 전후방적, 수직적, 횡적인 골격 부조화가 크거나 안면비대칭이 있는 경우, 또한 악교정수술후의 안정성이나 보다 이상적인 안모를 위하여 양악수술을 시행한다. 중안면부 함몰환자에서 안와하연과 관골부는 보존하며 비상악체를 전방이동하는 pyramidal Le Fort II osteotomy 를 시행할 수 있으며, 안와하연과 관골부치 전방이동을 필요로 할 때는 quadrangular Le Fort II osteotomy 를 시행할 수 있다. 이 수술법은 안와하연의 위치를 변화시켜 안와체적에 영향을 미치므로 상악골의 횡적, 수직적 이동량이 5 mm 이상일 때는 시행할 수 없다. 서울대학교병원 치과진료부 교정과에 내원하여 중안면부 함몰과 하악전돌을 동반한 골격성 III급 부정교합으로 진단되어 교정-악교정수술 (Le Fort II osteotomy 와 BSSRO) 복합치료를 받은 2명의 환자에 대해 살펴보고자 한다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제11권1호
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• pp.243-248
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• 1989

This is a report of 2 cases on old maxilla fractures accompanied with sagittal palatal fracture and severe malocclusion. We treated them by using of classic Le Fort I osteotomy and modified Le Fort I osteotomy along the old fracture lines satisfactorily. The results obtained from treatment are as follows : 1. Careful examination and correct care on sagittal palatal fracture should be need during initial diagnosis and emergency care of maxilla fracture showed malocclusion. 2. Although early definite treatment of maxilla injuries is difficult due to major organ injuries associated with accident, the positive effort to induce normal occlusion is always necessary as soon as possible. 3. In the cases of malocclusion due to transverse discrepancy of maxillary dentition associated with injury as like as our cases, classic and modified Le Fort I osteotomy and rigid internal fixation were useful to correct occlusion, to ease operation and return normal functions early.

• Archives of Plastic Surgery
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• 제50권1호
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• pp.54-58
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• 2023

Patients with Crouzon syndrome have increased risks of cerebrospinal fluid rhinorrhea and meningoencephalocele after LeFort III osteotomy. We report a rare case of meningoencephalocele following LeFort III midface advancement in a patient with Crouzon syndrome. Over 10 years since it was incidentally found during transnasal endoscopic orbital decompression, the untreated meningoencephalocele eventually led to intermittent clear nasal discharge, frontal headache, and seizure. Computed tomography and magnetic resonance imaging demonstrated meningoencephalocele in the left frontal-ethmoid-maxillary sinus through a focal defect of the anterior cranial base. Through bifrontal craniotomy, the meningoencephalocele was removed and the anterior cranial base was reconstructed with a pericranial flap and split calvarial bone graft. Secondary frontal advancement was concurrently performed to relieve suspicious increased intracranial pressure, limit visual deterioration, and improve the forehead shape. Surgeons should be aware that patients with Crouzon syndrome have the potential for an unrecognized dural injury during LeFort III osteotomy due to anatomical differences such as inferior displacement and thinning of the anterior cranial base.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제38권
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• pp.21.1-21.6
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• 2016

Background: The Le Fort I osteotomy is one of the most widely used and useful procedure to correct the dentofacial deformities of the midface. The changes of the maxilla position affect to overlying soft tissue including the nasal structure. Postoperative nasal septum deviation is a rare and unpredicted outcome after the surgery. There are only a few reports reporting the management of this complication. Case Presentation: In our department, three cases of the postoperative nasal septum deviation after the Le Fort I osteotomy had been experienced. Via limited intraoral circumvestibular incision, anterior maxilla, the nasal floor, and the anterior aspect of the septum were exposed. The cartilaginous part of the nasal septum was resected and repositioned to the midline and the anterior nasal spine was recontoured. Alar cinch suture performed again to prevent the sides of nostrils from flaring outwards. After the procedure, nasal septum deviation was corrected and the esthetic outcomes were favorable. Conclusion: Careful extubation, intraoperative management of nasal septum, and meticulous examination of preexisting nasal septum deviation is important to avoid postoperative nasal septum deviation. If it existed after the maxillary osteotomy, septum repositioning technique of the current report can successfully correct the postoperative septal deviation.

• 대한치과의사협회지
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• 제44권2호통권441호
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• pp.133-138
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• 2006

This is a report of one case about facial asymmetry involving maxilla & mandible. Le Fort I Maxillary Osteotomy & BSSRO is usually used for facial asymmetry patient involving maxilla & mandible. But Le Fort I Maxillary Osteotomy has demerits about more aggressive technique, more operation times, more discomforts of post operation nasal breathing than Unilateral maxillary Segmental Osteotomy. So we treated one patient successfully using Unilateral Maxillary Segmental Osteotomy, BSSRO & Post - Operation Rapid Orthodontics instead of Le Fort I Maxillary Osteotomy.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제13권1호
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• pp.88-94
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• 1991

Le Fort II 골절단술 및 전방 이동술은 비상악골의 형성 부전증이나 짧은 코, 또는 상악골에 대비하여 상대적인 하악 전돌증 환자에 있어 고려 대상이 되어 왔다. 이러한 비상악골 형성 부전증의 원인으로는 외상, 토순 또는 구개열로 인한 발육부전, 선천성 매독증과 같은 감염 증상 등을 들 수 있다. Le Fort II 골절단술 및 전방 이동술은 1973년 Henderson 과 Jackson 에 의해 처음으로 보고되었고, 그 후 1980년 Steinhauser, Kinnebrew 등에 의해 변화되어 왔다. Le Fort II 골절단술에 있어서의 관상 절개술은 paranasal incision에 비해 안면부 술후 반흔이 남지 않아 심미적으로 우수하며, 두부의 상부 1/2까지 노출이 가능하여 수술시야가 좋으며, 안면 신경 손상 및 lacrimal apparatus 손상의 위험이 적다는 장점 이 외에도 nasofronatal osteotomy site와 pterygomaxiliary osteotomy site를 위한 bone graft의 donor site로서 skull bone을 immediate로 사용할 수 있다는 장점이 있다. 본 교실에서는 선천성 매독의 후유증의 하나인 비상악골 형성부전증을 가진 23세의 여자 환자에 있어서 관상 절개술을 통한 Le Fort II 골절단술을 통한 전하방 이동 및 하악지의 시상골 절단술을 시행하여 양호한 결과를 얻었기에 이에 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권6호
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• pp.509-512
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• 2007

Purpose: The Le Fort I osteotomy is a commonly performed maxillary procedure for dentofacial deformity. One of the risks of this procedure is major hemorrhage resulting from injury to the descending palatine artery. So it is very important to know the exact position of the descending platine artery. An increased understanding of the position of this artery can minimize the intra-operative bleeding while allowing extension of the bone cuts to achieve exact positioning maxilla. The aim of this investigation was to study the position of the descending palatine artery as it relates to the Le Fort I osteotomy. Methods and patients: Total 40 patients who underwent Le Fort I osteotomy in SNUDH OMFS were studied in this study. We measured the distance from the pyriform aperture to the descending palatine artery (DPA distance) using a ruler. We investigated the relationship between DPA distance, the distance from A point to the McNamara line on lateral cephalography and the patient's body height. Results: The average distances from the pyriform rim to the descending palatine artery were 35.3 mm on the right (range: $30{\sim}40mm$) and 33.7mm (range: $30{\sim}41mm$) on the left in males. Those in females were 33.4 mm on the right (range: $28{\sim}40mm)$ and 32.8mm (range: $27{\sim}38mm$) on the left. The significances between the distance the DPA distance, the body height and the distance from A point to McNamara line were not found. Conclusion: Injury to the descending palatine artery during Le Fort I osteotomy can be minimized by not extending the osteotomy more than 30 mm posterior to the pyriform aperture in mal, and 27 mm in female.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권5호
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• pp.397-403
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• 2001

Purpose: The purpose of this study was to evaluate the postoperative stability of LeFort I osteotomy in two-jaw surgery of skeletal class III malocclusion and to help the establishment of treatment planning in patients with a skeletal class III malocclusion in the future. Materials and Methods: The lateral cephalograms of 14 patients who had been underwent two-jaw surgery via one-piece LeFort I osteotomy were traced and the landmarks were identified. Repeated tracings and construction of reference planes were done. Comparisons were made from the immediate postoperative to late postoperative results of each landmarks on the horizontal and vertical directions. Conclusions: 1. The horizontal changes of landmark ANS, point A, PNS and Mx6Rt between immediate postoperative to late postoperative data were statistically insignificant(p>0.05). 2. The vertical changes of landmark ANS, point A, PNS, Mx6Cr and Mx6Rt between immediate postoperative to late postoperative data were statistically insignificant(p>0.05). 3. The horizontal change of landmark Mx6Cr between immediate postoperative to late postoperative data was statistically significant(p<0.05). 4. Results showed that it was stable that one-piece LeFort I osteotomy in two-jaw surgery of skeletal class III malocclusion.

• 대한치과의사협회지
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• 제17권12호통권127호
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• pp.923-926
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• 1979

In patient of long standing malunited maxillary fracture, maxillary osteotomy or refracture seems to be justifiable. This is a case of the patient, a 60 year old Korean female patient, presented a long-standing malunited maxillary fracture with dish-type face and functional disturbance in mouth opening. We performed upon her Le Fort I osteotomy only via labial-buccal horizontal incisions in one-stag operation. The result was good in esthetics and function.