General Rules in Le Fort Osteotomies: Six Steps

Peter Kessler; Nicolas Hardt; Kensuke Yamauchi; Suen A.N. Lie

doi:10.1007/978-3-031-49869-5_16

General Rules in Le Fort Osteotomies: Six Steps

Peter Kessler^*
, Nicolas Hardt
, Kensuke Yamauchi
, Suen A.N. Lie

^*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceeding › Chapter › Academic

Abstract

The Le Fort osteotomies are composed of a logical sequence of surgical steps that must be consistently followed during each procedure in order to operate successfully, with clarity and safely. Basically six surgical steps can be distinguished, from incision to osteosynthesis. Even the incision can be decisive for obtaining a sufficient overview of the surgical area, which is in general located in the central midface, in direct neighborhood to the skull base and the orbits. The spaces between the mandible and the posterior maxilla must be created technically in such a way that the overview is not impeded or even made impossible by bleeding or remaining soft tissue attachments. Especially, the identification of pterygomaxillary junction must be ensured. In higher Le Fort osteotomies, the orbital contents and, if necessary, the brain must also be protected. Great importance must be attached to the completeness of the osteotomies. Only then Le Fort osteotomies or maxillary segment osteotomies will be successful.

Original language	English
Title of host publication	Illustrated Manual of Orthognathic Surgery: Osteotomies of the Maxilla and Midface
Editors	Peter Kessler, Nicolas Hardt, Kensuke Yamauchi
Publisher	Springer
Chapter	16
Pages	147-156
Number of pages	10
ISBN (Electronic)	9783031498695
ISBN (Print)	9783031498688
DOIs	https://doi.org/10.1007/978-3-031-49869-5_16
Publication status	Published - 1 Jan 2024

Keywords

Access to the spaces Midface degloving
Anatomical reference points in the midface
Avoidance of iatrogenic fractures
Identification of the pterygomaxillary junction
Instruments
Le Fort osteotomy
Mobilization and repositioning
Mucoperiosteal incision Transoral approach
Palatal artery
Perfusion Bleeding
Relevant clinical and topographic anatomy in the midface
Skull base
Surgical steps Osteotomy lines
Systematic approach

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10.1007/978-3-031-49869-5_16

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title = "General Rules in Le Fort Osteotomies: Six Steps",

abstract = "The Le Fort osteotomies are composed of a logical sequence of surgical steps that must be consistently followed during each procedure in order to operate successfully, with clarity and safely. Basically six surgical steps can be distinguished, from incision to osteosynthesis. Even the incision can be decisive for obtaining a sufficient overview of the surgical area, which is in general located in the central midface, in direct neighborhood to the skull base and the orbits. The spaces between the mandible and the posterior maxilla must be created technically in such a way that the overview is not impeded or even made impossible by bleeding or remaining soft tissue attachments. Especially, the identification of pterygomaxillary junction must be ensured. In higher Le Fort osteotomies, the orbital contents and, if necessary, the brain must also be protected. Great importance must be attached to the completeness of the osteotomies. Only then Le Fort osteotomies or maxillary segment osteotomies will be successful.",

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KW - Mobilization and repositioning

KW - Mucoperiosteal incision Transoral approach

KW - Palatal artery

KW - Perfusion Bleeding

KW - Relevant clinical and topographic anatomy in the midface

KW - Skull base

KW - Surgical steps Osteotomy lines

KW - Systematic approach

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BT - Illustrated Manual of Orthognathic Surgery: Osteotomies of the Maxilla and Midface

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A2 - Hardt, Nicolas

A2 - Yamauchi, Kensuke

PB - Springer

ER -

General Rules in Le Fort Osteotomies: Six Steps

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