Aesthetic and reconstructive surgery
Alternative approaches to pterygomaxillary separation
DrDennis T. Lanigan1 and Philip Guest2
1Division of Oral and Maxillofacial Surgery, Room 124, Dental Clinic Building, University of Saskatchewan, Saskatoon, Saskatchewan, S7N 0W0 Canada
2Oral and Maxillofacial Surgery, Manchester, UK
Accepted 10 January 1993.
Available online 18 March 2005.
Abstract
Pterygoid plate fractures, resulting from the pterygomaxillary separation in a Le Fort I osteotomy, may be associated with untoward fractures that extend to the base of the skull and orbit and which can lead to rare but significant complications. Five alternative approaches to the pterygomaxillary dysjunction were studied in 50 fresh cadavers. The results of this study show that the use of a curved Obwegeser osteotome to achieve the pterygomaxillary dysjunction should be abandoned, as it leads to an unacceptably high incidence of high-level pterygoid plate fractures at, or near, the base of the skull. The best results were obtained with a Stryker® micro-oscillating saw.
Key words: Le Fort I osteotomy; pterygomaxillary separation; pterygoid plate fractures; neurovascular complications
J Craniomaxillofac Surg. 1991 May;19(4):153-4.
Pterygoid plate separation using an oscillating saw in Le Fort I osteotomy.
Technical note.