关键词: 上颌骨, 截骨术, Le Fort, 鼻骨, 摄影测量法, 缝合技术

Abstract: Objective: To identify nasal width changes occurring after Le FortⅠosteotomy and to compare prospectively the effect of three surgical techniques for controlling postoperative nasal width.  Methods: In the study, 79 patients (22 male and 57 female, mean age 23.2±3.4 years), who received Le Fort Ⅰ osteotomy at Peking University Hospital of Stomatology from 2011 to 2014, were randomly divided into three groups. Group 1 was treated with traditional intraoral alar base cinch suture (ABCS); Group 2 with extraoral ABCS, and Group 3 with traditional ABCS plus an extra intraoral suture at points G.lat. All the patients had taken 3D photos using 3dMD camera before operation, and 3, and 6 months after operation. The nasal widths, which were indicated as distances between Sbal-Sbal, G.lat-G.lat and Al-Al, were measured by two examiners in the 3D photos three times with a time-interval of one week. SPSS 13.0 was used to do the statistic analysis. Results: At the end of the postoperative 6 months, the nasal widths lessened as compared with the postoperative 3 months. No significant differences were found between the three groups 6 months after the operation. The degree of the postoperative nasal width widening had positive correlation with that of the intraoperative nasal width widening, and had negative correlation with the initial nasal width and the amount of post-suture narrowing. Conclusion: There is no difference between three suturing techniques for controlling nasal width widening after Le Fort Ⅰ osteotomy. The postoperative nasal width-widening can’t be totally avoided, and the alteration might last at least 6 months after the operation. For patients with narrow nasal width and need to move maxilla forward, more overcorrection of ABCS is needed to control the postoperative nasal base widening.

Key words: Maxilla, Osteotomy, Le Fort, Nasal bone, Photogrammetry, Suture techniques