Akbulut N.
INTERNATIONAL JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, cilt.54, sa.Supplement 1, ss.225-226, 2025 (SCI-Expanded)
Özet
ntroduction/Background: The descending palatine artery (DPA) is primary bleeding source in Le Fort I osteotomy. Lateral nasal wall (LNW) and pterygomaxillary junction (PMJ) osteotomies are the most critical osteotomies, possibly damaging this artery.
Purpose: This study aimed to evaluate anatomical differences in the LNW and PMJ of patients with cleft lip and palate (CLP) and Class III dentofacial deformities (CDD) to establish safe entry margins for Le Fort I surgery.
Material & Method:s: Axial images of 45 CT scans (5 mm above the deepest nasal floor point) from CLP and CDD patients were analyzed. Linear and angular distances of the LNW and PMJ to the pterygopalatine canal were measured.
Results: Among 45 patients (mean age 26.15±6.49), 15 had unilateral complete cleft lip and palate (UCLP), 25 had CDD, and 5 had bilateral CLP (BCLP). In UCLP patients, angular and linear distances to the DPA were 33.87±4.49 mm and 32.79±4.6 mm on the cleft side, and 36.11±4.47 mm and 35.51±3.14 mm on the non-cleft side. In CDD patients, these distances were 38.27±2.67 mm and 37.01±2.6 mm on the right side, and 37.79±2.82 mm and 36.87±2.25 mm on the left side. Distances in UCLP cleft sides were significantly shorter than in CDD (p<0.001).
Conclusion: Anatomical challenges in the cleft side of UCLP patients necessitate meticulous osteotomy in the LNW and PMJ, compared to CDD.