OBJECTIVETo analysis the maxillary bony structures by three-dimensional CT in maxillary retrognathism patients so as to provide information for Le Fort I osteotomy.

METHODS20 maxillary retrognathism patients underwent Le Fort I osteotomy, while 20 patients with simple mandibular fractures were included as control group. All the patients received Skull 3-D CT before operation. The measurement about descending palatine artery and wing palatal was performed by Surgicase 5.0. The data were analyzed statistically.

RESULTSThe average distance from the piriform aperture margin to wing palatal tube was (33.74 +/- 6.74) mm in the retrognathism group; while (35.67 +/- 7.50) mm in the control group, showing a significant difference between the two groups (P < 0.05), but there was no statistically difference in the height of pterygomaxillary junction between the two groups.

CONCLUSIONThe safe depth for Le Fort I osteotomy in patients with hypoplasia maxilla is 32 mm. CT scanning can provide guidance for osteotomy.

Adolescent ; Arteries ; Humans ; Maxilla ; surgery ; Osteotomy, Le Fort ; methods ; Palate ; blood supply ; Radiography, Interventional ; methods ; Retrognathia ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed

We investigated the surgical outcome of radical maxillectomy in advanced maxillary sinus cancers invading through the posterior wall and into the infratemporal fossa. Twenty-eight patients with maxillary sinus squamous cell carcinoma, who visited the Otorhinolaryngology Department at Severance Hospital from March, 1993 to February, 2001 and underwent the surgery, were analyzed retrospectively by reviewing clinical medical records and radiologic test results. The mean follow- up period was 78.8 months. (26 -162 months) Local recurrence, sites of local recurrence, and the 2-year disease-free survival rate were analyzed. Of the total 28 cases, 9 cases were T3, and 19cases were T4. Total maxillectomy was performed in 12 cases (42.9%) and radical maxillectomy in 16 cases (57.1%). Regardless of staging, radical maxillectomy was performed only when cancers invaded through the posterior wall and into the infratemporal fossa. When cancers only maginally or did not invade the posterior wall, total maxillectomy was performed. The 2-year disease-free survival rate was 75% for both total and radical maxillectomy, and the local recurrence rates were 8.3% and 18.7% respectively. All recurrence occurred at the posterior resection margin of the maxillectomy. We strongly recommend the use of radical maxillectomy in the cases of advanced maxillary sinus cancers invading the infratemporal fossa. Radical maxillectomy can provide sufficient safety margins and lower the local recurrence rate.
Adult ; Aged ; Carcinoma, Squamous Cell/mortality/pathology/*surgery ; Disease-Free Survival ; Female ; Humans ; Male ; Maxilla/blood supply/*surgery ; Maxillary Artery/surgery ; Maxillary Neoplasms/mortality/pathology/*surgery ; Maxillary Sinus/*surgery ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Retrospective Studies ; Survival Rate ; Tomography, X-Ray Computed ; Treatment Outcome