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7 results

  • Is angular artery trauma seen frequently in lateral osteotomy and responsible for peri-orbital ecchymosis?

  • Z Onerci Altunay, T M Onerci
  • Journal:
    The Journal of Laryngology & Otology / Volume 134 / Issue 12 / December 2020
    Published online by Cambridge University Press:
    12 January 2021, pp. 1094-1095
    Print publication:
    December 2020
  • Objective

    This study was performed on fresh frozen cadavers to investigate the role of angular artery damage.

    Methods

    Lateral osteotomies (‘high-low-high’ method) were carried out bilaterally, with a 4 mm guarded lateral osteotome, after the creation of a subperiosteal tunnel. Following completion of the lateral osteotomy, a skin incision was made in the midline dorsum. The dermis and subcutaneous tissues were carefully dissected, taking care not to damage the angular artery. Overlying tissues were cut and retracted to show the course of the angular artery.

    Results

    The angular artery was not damaged in any of the cadavers. The angular artery was always lateral to the lateral osteotomy line.

    Conclusion

    The high-low-high lateral osteotomy does not damage or traumatise the angular artery. The ecchymosis and oedema are related to other factors.

  • Massive epistaxis due to pseudoaneurysm of the sphenopalatine artery: a rare post-operative complication of orthognathic surgery

  • Y-W Kim, M-J Baek, H-D Kim, K-S Cho
  • Journal:
    The Journal of Laryngology & Otology / Volume 127 / Issue 6 / June 2013
    Published online by Cambridge University Press:
    22 April 2013, pp. 610-613
    Print publication:
    June 2013
  • Objective:

    To introduce pseudoaneurysm of the sphenopalatine artery as the possible aetiology of acute massive epistaxis in patients with a history of orthognathic surgery accompanied by Le Fort I osteotomy.

    Methods:

    Case report and literature review.

    Results:

    This paper reports a case of acute life-threatening epistaxis following Le Fort I osteotomy. Computed tomography and angiography showed a pseudoaneurysm of the sphenopalatine artery, which was successfully treated by endovascular embolisation.

    Conclusion:

    Although a pseudoaneurysm of the sphenopalatine artery following Le Fort I osteotomy is extremely rare, it should be considered as the possible aetiology of acute massive epistaxis in patients with a history of orthognathic surgery accompanied by Le Fort I osteotomy.

  • The gummy smile

  • Thierry Piral
  • Journal:
    Journal of Dentofacial Anomalies and Orthodontics / Volume 15 / Issue 1 / 2012
    Published online by Cambridge University Press:
    16 April 2012, 103
    Print publication:
    2012

  • A gummy smile is one in which excessive amounts of gingival tissue are revealed as individuals begin to laugh or when they show their teeth in a smile.

    In addition to cosmetic methods of concealing this condition, a variety of orthodontic and surgical procedures can, independently or in conjunction, modify the structural elements that constitute a gummy smile.

    Nevertheless marked gummy smiles are always characterized by specific dento-maxillary discrepancies, a global vertical maxillary excess or overdevelopment of the alveolar processes, the premaxilla and the proalveolus constituting excess anterior vertical dimension. For each of these instances, the author proposes therapeutic treatment plans and illustrates them with corresponding clinical cases.

  • Single, subcondylar mandibular osteotomy: a new access route for extensive, benign parapharyngeal neoplasms

  • B Bianchi, A Ferri, S Ferrari, C Copelli, A S Magri, E Sesenna
  • Journal:
    The Journal of Laryngology & Otology / Volume 124 / Issue 8 / August 2010
    Published online by Cambridge University Press:
    10 March 2010, pp. 909-912
    Print publication:
    August 2010
  • Objective:

    We report a new approach to benign parapharyngeal space tumours: a single, subcondylar mandibular osteotomy.

    Method:

    Case report and review of the world literature concerning parapharyngeal space access and the various types of mandibular osteotomy.

    Results:

    The use of a single, subcondylar mandibular osteotomy achieves good exposure and satisfactory aesthetic and functional results, using a simple, easily performed technique that is fast and has minimal morbidity. In addition, this technique preserves the submandibular gland and avoids lip-splitting and post-operative intermaxillary fixation.

    Conclusion:

    To our knowledge, this is the first report of this approach to the parapharyngeal space. We propose this approach as the first choice for resection of benign neoplasms of the parapharyngeal space.

  • Rationale for osteotome selection in rhinoplasty

  • Heung-Man Lee, Hee Joon Kang, Jin Ho Choi, Sung Won Chae, Sang Hag Lee, Soon Jae Hwang
  • Journal:
    The Journal of Laryngology & Otology / Volume 116 / Issue 12 / December 2002
    Published online by Cambridge University Press:
    08 March 2006, pp. 1005-1008
    Print publication:
    December 2002

  • Proper selection of an osteotome for nasal osteotomy is important for minimizing soft tissue trauma. Radiographic analysis of the facial bony lateral wall thickness was performed to suggest a guideline for an appropriate osteotome size for Asians. Facial bone computed tomography (CT) of 100 patients (50 male, 50 female) were studied. The thickness of the facial bony lateral wall at three points along the track of a lateral osteotomy, and two points along the track of a medial osteotomy and intermediate osteotomy were measured. The average bony thickness along the track of a lateral osteotomy was 2.61 ± 0.66 mm at the low level, 2.75 ± 0.76 mm at the middle level, and 2.72 ± 0.53 mm at the high level in subjects. The average bony thickness along the track of an intermediate osteotomy were 1.26 ± 0.34 mm at the low level, and 1.31 ± 0.32 mm at the high level in the subjects. The average bony thickness along the track of the medial osteotomy were 2.54 ± 0.31 mm at the lowlevel, and 2.77 ± 0.30 mm at the high level in subjects. These results may provide a guideline for choosing an osteotome of appropriate size for the Asian population.