CT画像を用いた上顎Le Fort I型骨切り術による上顎前方移動時の骨接触について

抄録

This study simulated the bone support after maxillary advancement by CT images and evaluated morphological characteristics of maxillary sinus in Le Fort I osteotomy sites. For forty-nine Japanese jaw deformity patients, CT images were taken before orthognathic surgery. In 3mm and 5mm maxillary advancement, the overlap of bone images was examined from the CT images 2mm above the anterior nasal spine of maxilla. The results were as follows: All cases had bony contact at the lateral piriform rim, the base of the zygomatic process of the maxilla and the medial wall of the sinus in 5mm maxillary advancement. Few cases had bony contact at the anterior wall in 3mm. Some cases had it at the posterior wall in 3mm or 5mm. The shape of the posterior wall of the maxillary sinus was subjectively grouped into the following three types: Straight type, S type or J type. In the S and J types, the percentage of bony contact of the posterior wall after maxillary advancement was higher than that in the Straight type.
These findings suggest that the preoperative CT scan along the osteotomy line is clinically useful.