Morphometric analysis of pterygomaxillary region by using cone beam computed tomography

Area of Science:

• Oral and Maxillofacial Surgery
• Radiology
• Anatomy

Background:

• Le Fort I osteotomy is a common surgical procedure for midface advancement.
• Pterygomaxillary separation during this surgery can lead to various complications.
• Anatomical variations in the pterygomaxillary region may contribute to these complications.

Purpose of the Study:

• To evaluate the anatomical characteristics of the pterygomaxillary region using cone-beam computed tomography (CBCT).
• To identify potential anatomical factors influencing complications during Le Fort I osteotomy.

Main Methods:

• CBCT scans of 200 patients (100 males, 100 females) were analyzed.
• Measurements included pterygomaxillary region thickness and width, descending palatine artery location, and pterygoid plate length.
• Analysis was performed on axial sections.

Main Results:

• Males had a greater distance between the descending palatine canal and piriform rim (P=0.037).
• Females exhibited longer medial pterygoid plates (right P=0.0001, left P=0.025) and thicker pterygomaxillary regions (P=0.000).
• The distance between the pterygomaxillary fissure and descending palatine canal was greater on the right side (P=0.001).

Conclusions:

• The pterygomaxillary region displays sex-specific anatomical variations.
• These anatomical differences may predispose patients to specific complications during Le Fort I osteotomy.
• Preoperative CBCT evaluation is recommended to identify potential risks and plan surgical approaches accordingly.