Le Fort III型骨切り術を施行したCrouzon病患者の術前術後の顎態評価

抄録

Crouzon's disease is one of the most common craniofacial syndromes that occur due to premature closure of cranial sutures. It is characterized by craniosynostosis, calvarial deformity, maxillary hypoplasia resulting in relative mandibular prognathism, hypertelorism, and exophthalmos. In this paper, the clinical findings and the treatment process of a twelveyear-old male patient with Crouzon's disease who underwent surgical orthodontic treatment before adolescence were reported.
1. This patient presented hypertelorism, disturbance of eyelid closing dueto exophthalomos, and skeletal class III malocclusion caused by growth retardation of the maxilla.
2. Frontal advancement was performed in order to cure the neurological symptons whilethe preoperative orthodontic treatment was underway.
3. Le Fort III osteotomy was performed by moving the mid-face in the forwardand downward direction, as well as by rotating it clockwisely. The mandible also rotated clockwisely as a result of the displacement of the mid-face. The soft tissue profile and occlusion was markedly improved in this case.
4. Immediatelyafter surgery, upward maxillary movement was observed. The condylar position in the fossa looked more favorable by roentgenographic observation after one year and seven months of treatment than that at the initial stage.