Effect of Customized Lateral Nasal Wall Osteotomy on the Pterygomaxillary Separation During le Fort I Down-fracture
- Conditions
- MalocclusionOrthognathic SurgeryLe Fort; IOpen Bite
- Interventions
- Procedure: orthogantic surgery
- Registration Number
- NCT06233188
- Lead Sponsor
- Bezmialem Vakif University
- Brief Summary
The goal of this clinical trial is to show the effect of patient specific lateral nasal wall osteotomy to the pterygomaxillary separation during Le Fort I down-fracture.
Participants will be divided into two treatment groups. In study group, surgery planned according to the patients' indivudial anatomy and in the conventional group, surgery planned according to mean anatomical datas.
Researchers will compare patient specific lateral nasal wall osteotomy to see if it affects the pterygomaxillary junction seperation during le fort I downfracture.
- Detailed Description
The same surgical team performed the osteotomies under general anesthesia with nasotracheal intubation. Hypotensive anesthesia was applied as a standard protocol in all patients. Orthognathic surgery, including Le Fort I and sagittal split ramus osteotomy, was used to correct skeletal deformities.
Bone osteotomy was initiated on the bilateral wall of the maxilla with piezosurgery after a mucosal incision and flap elevation.Lateral nasal osteotomy (LNO) with Nievert Anderson single guarded osteotome, median septum separation with double guarded U-shaped osteotome, and pterygomaxillary junction separation with curved osteotome were performed before the down-fracture. The only difference between the conventional and study groups was the depth of the LNO. In the study group, LNO was performed at a depth of 2 mm less than the measured distance in the axial section. In the conventional osteotomy group, LNO was performed at 30 mm for females and 35 mm for males, as suggested in the literature. A curved osteotome and a mallet were used in each case to separate the pterygomaxillary junction. The down-fracture of the maxilla was performed using a hook and a bone spreader in all patients. When the maxilla was down-fractured, LNW and the pterygomaxillary separation types were assessed intraoperatively. The maxilla was stabilized in its new position by four L-shaped osteosynthesis mini-plates at the zygomaticomaxillary buttress and the aperture piriformis regions.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 43
The inclusion criteria
- orthognathic surgery to treat malocclusion
- sleep apnea
- jaw asymmetry
- cleft lip and palate
- previous orthognathic surgery
- rhinoplasty
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description conventional group orthogantic surgery n the conventional osteotomy group, lateral nasal osteotomy was performed 25 mm for female and 30 mm for male patients, as suggested in the literature. study group orthogantic surgery In the study group, lateral nasal osteotomy was performed 2 mm less than the measured distance in the axial section
- Primary Outcome Measures
Name Time Method lateral nasal wall separation 1 year The primary outcome variable is lateral nasal wall separation:
Type 1 Separation from the osteotomy line
Type 2 Separation 2-4 mm above the osteotomy line
Type 3 Separation 4 mm or more above the osteotomy line
- Secondary Outcome Measures
Name Time Method pterygomaxillary junction separation 1 year The secondary outcome variable is pterygomaxillary separation
Type 1 Separation including the tuber maxilla
Type 2 Separation from the pterygomaxillary junction
Type 3 Separation including the pterygoid plates
Trial Locations
- Locations (1)
Taha Pergel
🇹🇷Istanbul, Fatih, Turkey