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SHR Neuro Krebs Kardio Lipid

Bruneder, S; Wallner, J; Weiglein, A; Kmečová, Ĺ; Egger, J; Pilsl, U; Zemann, W.
Anatomy of the Le Fort I segment: Are arterial variations a potential risk factor for avascular bone necrosis in Le Fort I osteotomies?
J Craniomaxillofac Surg. 2018; 46(8):1285-1295
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Autor/innen der Med Uni Graz:
Bruneder Simon
Pilsl Ulrike
Wallner Jürgen
Weiglein Andreas
Zemann Wolfgang
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Abstract:
Osteotomies of the Le Fort I segment are routine operations with low complication rates. Ischemic complications are rare, but can have severe consequences that may lead to avascular bone necrosis of the Le Fort I segment. Therefore the aim of this study was to investigate the blood supply and special arterial variants of the Le Fort I segment responsible for arterial hypoperfusion or ischemic avascular necrosis after surgery. The arterial anatomy of the Le Fort I segment's blood supply using 30 halved human cadaver head specimens was analyzed after complete dissection until the submicroscopic level. In all specimens the arterial variants of the Le Fort I segment and also the arterial diameters measured at two points were evaluated. The typical known vascularization pattern was apparent in 90% of all specimens, in which the ascending palatine (D1: 1,2 mm ± 0,34 mm; D2: 0,8 mm ± 0,34 mm) and ascending pharyngeal artery (D1: 1,3 mm ± 0,58 mm; D2: <0,4 mm) were both supplying the Le Fort I segment. However in 10% of all specimens, the Le Fort I segment was dependent on the ascending pharyngeal artery alone and the missing ascending palatine artery was replaced with the anterior branch of the ascending pharyngeal artery (D1: 1,9 mm ± 0,32; D2: 1,0 mm ± 0,3 mm). This study is the first description of a special type of arterial variation of the Le Fort I segment. The type of this arterial variation, its clinical relevance and potential consequences are explained. Individuals with this special arterial anatomy may clinically be at a high risk for hypoperfusion and avascular segment necrosis after surgery. An individualized operation plan may prevent ischemic complications in at-risk patients. Copyright © 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Find related publications in this database (Keywords)
Le Fort I segment
Le Fort I anatomy
Le Fort I osteomy
Blood supply
Avascular bone necrosis
Arterial variations
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