Maxillary perfusion during Le Fort I osteotomy after ligation of the descending palatine artery.
OBJECTIVE
Controversy exists regarding management of the descending palatine artery (DPA) during Le Fort I osteotomy. Some surgeons advocate preserving the DPA, and others ligate the vessels. The purpose of this study was to evaluate maxillary gingival blood flow (GBF) during Le Fort I osteotomy in a sample of patients with and without ligation of the DPA.


METHODS
Using a prospective randomized clinical study, we enrolled a study sample composed of 34 patients undergoing Le Fort I osteotomy. The patients were randomly assigned to either study group 1 (16) (DPA ligated) or group 2 (18) (DPA preserved). To measure maxillary GBF during the operation, we used laser Doppler flowmetry (LDF). The predictor variable was status of DPA management (ligated or preserved). The outcome variable was change in GBF over time.


RESULTS
(DPA). Before ligation (or simulated ligation) of the DPA, the mean GBF for groups 1 and 2 was 11.4 +/- 8.6 and 11.9 +/- 9.4 mL/min/100 g tissue, respectively (P = .88). After ligation of the DPA in group 1, the mean GBF was 10.0 +/- 7.7 mL/min/100 g tissue. At the corresponding time in group 2 (DPA preserved), the mean GBF was 12.6 +/- 9.4 mL/min/100 g tissue. The difference in mean GBF between groups 1 and 2 was not statistically significant (P = .43).


CONCLUSIONS
There were no statistically significant differences in mean maxillary GBF between patients having the DPA ligated and those having the DPA preserved as measured using LDF during Le Fort I osteotomy.
Dodson
T B
TB
Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA.
Bays
R A
RA
Neuenschwander
M C
MC
D000293:Adolescent; D000328:Adult; D001158:Arteries; D005260:Female; D005881:Gingiva / Q000098:blood supply*; D006801:Humans; D008297:Male; D008437:Maxilla; D010027:Osteotomy / Q000379:methods*; D011446:Prospective Studies; D012039:Regional Blood Flow