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Effects on contiguous anatomical structures by disarticulation of the pterygo‐palato‐maxillary suture without the Le Fort I component
Author(s) -
Mintz Sheldon M.,
Ettinger Anna C.,
Demetropoulos Kyriakus C.
Publication year - 1989
Publication title -
clinical anatomy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.667
H-Index - 71
eISSN - 1098-2353
pISSN - 0897-3806
DOI - 10.1002/ca.980020407
Subject(s) - cadaver , medicine , disarticulation , anatomy , fibrous joint , magnification , radiography , ossification , osteotome , soft tissue , gross examination , dentistry , osteotomy , surgery , pathology , computer science , computer vision , amputation
Abstract The conflicting reports of fractures following Le Fort I osteotomies may reflect the different types of specimens and techniques used. One report suggested that fractures could be avoided with proper placement of a newly designed osteotome. The results of a linear growth study tend to dispute that contention as it showed that interdigitating osseous bridges connect the components of the pterygo‐palato‐maxillary complex and fractures would occur with any attempted separation. The purpose of this radiographic and anatomic investigation was to review the suture patterns of this complex on dry adult skulls and to use cadaver specimens to determine the effects of separation of the pterygo‐palato‐maxillary articulations on the concomitant bones. The major palatine canals of 11 hemisected cadaver specimens were cannulated with a #18 angiocatheter, and renografin 76 media was injected. Lateral radiographs of the specimens were obtained using digital radiographic equipment. Soft tissue was removed and a gross examination of the bony structures was performed using a × 10 magnification dissecting microscope. The variations in the sutures of this bony complex were studied on 143 dry adult skulls. In all the cadaver specimens, the pterygoid plates were fractured but the major palatine canals remained intact. Four specimens had maxillary fractures. An examination of the dry skulls showed a wide variation of suture lines and varying degrees of ossification that may explain the incidence of certain types of fractures. Improved visualization of the sutural anatomy during surgery is needed to facilitate better separation and minimize postoperative trauma.