Location of the descending palatine artery in relation to the Le Fort I osteotomy in Koreans

Lee, Il Gu; Myoung, Hoon; Hwang, Soon Jung; Seo, Byoung Moo; Lee, Jong Ho; Choung, Pill Hoon; Kim, Myung Jin; Choi, Jin Young

Abstract

PURPOSE: The Le Fort I osteotomy is a commonly performed maxillary procedure for dentofacial deformity. One of the risks of this procedure is major hemorrhage resulting from injury to the descending palatine artery. So it is very important to know the exact position of the descending platine artery. An increased understanding of the position of this artery can minimize the intra-operative bleeding while allowing extension of the bone cuts to achieve exact positioning maxilla. The aim of this investigation was to study the position of the descending palatine artery as it relates to the Le Fort I osteotomy.
METHODS
AND PATIENTS: Total 40 patients who underwent Le Fort I osteotomy in SNUDH OMFS were studied in this study. We measured the distance from the pyriform aperture to the descending palatine artery ( DPA distance ) using a ruler. We investigated the relationship between DPA distance, the distance from A point to the McNamara line on lateral cephalography and the patient's body height.
RESULTS
The average distances from the pyriform rim to the descending palatine artery were 35.3 mm on the right ( range : 30 ~ 40 mm ) and 33.7 mm ( range : 30 ~ 41 mm ) on the left in males. Those in females were 33.4 mm on the right ( range : 28 ~ 40 mm ) and 32.8 mm ( range : 27 ~ 38 mm ) on the left. The significances between the distance the DPA distance, the body height and the distance from A point to McNamara line were not found. ( Simple Regression Analysis )
CONCLUSION
Injury to the descending palatine artery during Le Fort I osteotomy can be minimized by not extending the osteotomy more than 30 mm posterior to the pyriform aperture in male, and 27 mm in female.