title: U-shaped Osteotomy Around the Descending Palatine Artery to Prevent Posterior Osseous Interference for Superior/Posterior Repositioning of the Maxilla in Le Fort I Osteotomy.
abstract: In maxillary orthognathic surgery, superior repositioning of the maxilla is sometimes difficult, and removal of bony interference, especially around the descending palatine artery (DPA), is very time-consuming in cases of severe maxillary impaction. Posterior repositioning of the maxilla for removal of bony interference between the posterior maxilla and the pterygoid process is also technically difficult. Because the most common site of hemorrhage in Le Fort I osteotomy is the posterior maxilla, this bone removal is a source of frustration for surgeons in DPA injury. When the DPA is injured during bone removal and ligation is performed, aseptic necrosis of the maxilla may occur. Therefore, a simple and safe method for maxillary superior/posterior repositioning is required to remove osseous interference around the DPA. The authors describe here U-shaped osteotomy around the DPA to prevent posterior osseous interference for superior/posterior repositioning of the maxilla in Le Fort I osteotomy.
authors.affiliation: *Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Medical Center †Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Omura
authors.forename: Toshinori
authors.initials: T
authors.lastname: Iwai
authors.forename: Koji
authors.initials: K
authors.lastname: Honda
authors.forename: Naoki
authors.initials: N
authors.lastname: Shibutani
authors.forename: Koichi
authors.initials: K
authors.lastname: Fujita
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Hikaru
authors.initials: H
authors.lastname: Takasu
authors.forename: Shogo
authors.initials: S
authors.lastname: Murata
authors.forename: Iwai
authors.initials: I
authors.lastname: Tohnai
mesh_terms: D000766:Anesthesia, Dental; D000772:Anesthesia, Local; D001158:Arteries / Q000293:injuries / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control*; D008437:Maxilla / Q000098:blood supply* / Q000601:surgery*; D056948:Orthognathic Surgical Procedures / Q000379:methods*; D010027:Osteotomy / Q000379:methods*; D019340:Osteotomy, Le Fort / Q000379:methods*; D010159:Palate / Q000098:blood supply* / Q000601:surgery*