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Related Experiment Videos

Alternative approaches to pterygomaxillary separation

D T Lanigan1, P Guest

  • 1Division of Oral and Maxillofacial Surgery, University of Saskatchewan, Saskatoon, Canada.

International Journal of Oral and Maxillofacial Surgery
|June 1, 1993
PubMed
Summary

Le Fort I osteotomy can cause pterygoid plate fractures. A Stryker micro-oscillating saw is recommended over the Obwegeser osteotome to avoid skull base fractures during pterygomaxillary dysjunction.

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Anatomical Studies
  • Surgical Techniques

Background:

  • Le Fort I osteotomy is a common surgical procedure for midface correction.
  • Pterygomaxillary separation during this procedure can lead to pterygoid plate fractures.
  • These fractures may extend to the skull base and orbit, causing rare but significant complications.

Purpose of the Study:

  • To evaluate alternative surgical approaches for pterygomaxillary dysjunction in Le Fort I osteotomy.
  • To identify techniques that minimize the risk of high-level pterygoid plate fractures.
  • To compare the efficacy and safety of different instruments for pterygomaxillary separation.

Main Methods:

  • The study involved dissecting 50 fresh cadavers.
  • Five distinct methods for achieving pterygomaxillary dysjunction were analyzed.

Related Experiment Videos

  • Fracture patterns and locations were meticulously documented for each method.

    • Main Results:

    • The use of a curved Obwegeser osteotome resulted in a high incidence of pterygoid plate fractures near the skull base.
    • These fractures were deemed unacceptable due to their proximity to critical structures.
    • The Stryker micro-oscillating saw demonstrated superior outcomes with significantly fewer high-level fractures.

    Conclusions:

    • The Obwegeser osteotome technique for pterygomaxillary dysjunction should be discontinued.
    • The Stryker micro-oscillating saw is the preferred instrument for pterygomaxillary separation in Le Fort I osteotomy.
    • Utilizing the oscillating saw enhances surgical safety by reducing the risk of complex fractures.