[Transpalatal modified Le Fort I osteotomy for correction of maxillary hypoplasia in cleft lip and palate patients: a preliminary clinical application].
OBJECTIVE
To evaluate the surgical corrective results of maxillary hypoplasia in patients with cleft lip and palate withtranspalatal modified Le Fort I osteotomy.


METHODS
In the study, 11 patients (4 women, and 7 men) with maxillary hypoplasia secondary to cleft lip and palate underwent transpalatal modified Le Fort I osteotomy at Peking University School of Stomatology from Jan. 2012 to Dec. 2013,with the mean age of 21 years ( from 18 to 27 years), Bilateral sagittal split ramus osteotomy (BSSRO)and genioplasty were performed simultaneously in 9 of them for better appearance and functional occlusion. Lateral cephalometric radiographs were taken and traced before surgery, immediately after surgery and 6 months after surgery. The position of subspinale (A) on horizontal direction, the angle of sella-nasion-subsipmale (SNA) and the angle of sella-nasion-supramental (SNB) were collected and analyzed to evaluate the results.


RESULTS
All the patients were uneventful with transpalatal modified Le Fort I osteotomy. All of them had a better profile and a satisfactory occlusionafter operation.The position of A was moved forward (6.6±1.1) mm on average in horizontal direction when surgery was completed, and maintained (6.0±1.2) mm on average 6 months after surgery. The average of SNA was 75.9°±2.8° before surgery,81.6°±8.6° immediately after surgery, and maintained 81.0°±2.6° 6 months after surgery. The average of SNB was 82.6°±3.7° before surgery, 78.0°±2.4° immediately after surgery, and maintained 78.5°±2.4° 6 months after surgery.


CONCLUSIONS
The maxillary hypoplasia in cleft lip and palate patients can be successfully corrected with transpalatal modified Le Fort I osteotomy and the functional occlusion can be achieved simultaneously. The effect of deformity correction was satisfactory. Transpalatal modified Le Fort I osteotomy can move maxilla more sufficiently, especially applicable for the patient with severe palatal scars preoperatively.
Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China; Department of Stomatology, Peking University Third Hospital, Beijing 100191, China.
Y
Y
Wu
Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China.
Z L
ZL
Li
Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China.
X
X
Wang
Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China.
B
B
Yi
Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China.
L
L
Ma
D000293:Adolescent; D000328:Adult; D002508:Cephalometry; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla / Q000473:pathology / Q000601:surgery*; D019340:Osteotomy, Le Fort; D055815:Young Adult