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The Le Fort I Osteotomy Approach for Nasopharyngeal and Nasal Fossa Tumors

The Le Fort I Osteotomy Approach for Nasopharyngeal and Nasal Fossa Tumors Abstract • The nasopharynx, pterygopalatine fossa, and nasal fossa are difficult areas in which to gain wide surgical access. The transverse maxillary osteotomy with downfracturing of the entire palate and inferior maxilla has recently been adopted as a surgical option. Simultaneous bilateral wide surgical exposure is achieved in the maxillary, ethmoidal, and sphenoidal sinuses, nasal fossa, clivus, pterygopalatine fossa, and medial portion of the infratemporal fossa. Compared with other popular techniques, the transverse maxillary osteotomy provides excellent exposure for angiofibromas, clivus tumors, and other tumors of the central base of the skull and midface regions. The details of the procedure and relevant physiology of the osteotomized segment are presented. The safe attainment of wide surgical exposure will be demonstrated. This procedure has worldwide acceptance for orthognathic surgery and is easily adapted to head and neck oncologic surgery. (Arch Otolaryngol Head Neck Surg 1988;114:751-754) References 1. Michaux (1853), referenced by Wilson CP: The approach to the nasopharynx . Proc R Soc Med 1950;44:353-358. 2. Von Langenbeck B: Beitrage zur Osteoplastik , in Goschen A (ed): Die Osteoplastische Resektion des Oberkiefers . Berlin, Reimer, 1859. 3. Drommer RB: The history of the 'Le Fort I osteotomy.' J Maxillofac Surg 1986;14:119-122.Crossref 4. Lanz O: Osteoplastische Resktion bei der Oberkiefer nach Kocher , in Lucke R (ed): Deutsche Zeitschrift für Chirurgie . Leipzig, East Germany, Vogel, 1893. 5. Wassmund M: Lehrbuch der praktischen Chirurgie des Mundes und Kiefer . Leipzig, East Germany, Meusser, 1935, vol 1. 6. Axhausen G: Zur Behandlung veralteter desloziert veheilter Oberkieferbruche . Dtsch Zahn Mund Kieferheilk 1934;1:334-339. 7. Bell WH: Le Fort I osteotomy for correction of maxillary deformities . J Oral Surg 1957;33:412-426. 8. Paavolainen M, Malmberg H: Sublabial approach to the nasal and paranasal cavities using nasal pyramid osteotomy and septal transection . Laryngoscope 1986;96:106-108.Crossref 9. Bell WH, Fonseca RJ, Kennedy JW, et al: Bone healing and revascularization after total maxillary osteotomy . J Oral Surg 1975;33:253-260. 10. Nelson RL, Path MG, Ogle RG, et al: Quantitation of blood flow after Le Fort I osteotomy . J Oral Surg 1977;35:10-16. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology - Head & Neck Surgery American Medical Association

The Le Fort I Osteotomy Approach for Nasopharyngeal and Nasal Fossa Tumors

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References (10)

Publisher
American Medical Association
Copyright
Copyright © 1988 American Medical Association. All Rights Reserved.
ISSN
0886-4470
eISSN
1538-361X
DOI
10.1001/archotol.1988.01860190055022
Publisher site
See Article on Publisher Site

Abstract

Abstract • The nasopharynx, pterygopalatine fossa, and nasal fossa are difficult areas in which to gain wide surgical access. The transverse maxillary osteotomy with downfracturing of the entire palate and inferior maxilla has recently been adopted as a surgical option. Simultaneous bilateral wide surgical exposure is achieved in the maxillary, ethmoidal, and sphenoidal sinuses, nasal fossa, clivus, pterygopalatine fossa, and medial portion of the infratemporal fossa. Compared with other popular techniques, the transverse maxillary osteotomy provides excellent exposure for angiofibromas, clivus tumors, and other tumors of the central base of the skull and midface regions. The details of the procedure and relevant physiology of the osteotomized segment are presented. The safe attainment of wide surgical exposure will be demonstrated. This procedure has worldwide acceptance for orthognathic surgery and is easily adapted to head and neck oncologic surgery. (Arch Otolaryngol Head Neck Surg 1988;114:751-754) References 1. Michaux (1853), referenced by Wilson CP: The approach to the nasopharynx . Proc R Soc Med 1950;44:353-358. 2. Von Langenbeck B: Beitrage zur Osteoplastik , in Goschen A (ed): Die Osteoplastische Resektion des Oberkiefers . Berlin, Reimer, 1859. 3. Drommer RB: The history of the 'Le Fort I osteotomy.' J Maxillofac Surg 1986;14:119-122.Crossref 4. Lanz O: Osteoplastische Resktion bei der Oberkiefer nach Kocher , in Lucke R (ed): Deutsche Zeitschrift für Chirurgie . Leipzig, East Germany, Vogel, 1893. 5. Wassmund M: Lehrbuch der praktischen Chirurgie des Mundes und Kiefer . Leipzig, East Germany, Meusser, 1935, vol 1. 6. Axhausen G: Zur Behandlung veralteter desloziert veheilter Oberkieferbruche . Dtsch Zahn Mund Kieferheilk 1934;1:334-339. 7. Bell WH: Le Fort I osteotomy for correction of maxillary deformities . J Oral Surg 1957;33:412-426. 8. Paavolainen M, Malmberg H: Sublabial approach to the nasal and paranasal cavities using nasal pyramid osteotomy and septal transection . Laryngoscope 1986;96:106-108.Crossref 9. Bell WH, Fonseca RJ, Kennedy JW, et al: Bone healing and revascularization after total maxillary osteotomy . J Oral Surg 1975;33:253-260. 10. Nelson RL, Path MG, Ogle RG, et al: Quantitation of blood flow after Le Fort I osteotomy . J Oral Surg 1977;35:10-16.

Journal

Archives of Otolaryngology - Head & Neck Surgery – American Medical Association

Published: Jul 1, 1988

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