Anatomy of the Le Fort I segment: Are arterial variations a potential risk factor for avascular bone necrosis in Le Fort I osteotomies?

Bruneder, Simon; Wallner, Jürgen; Weiglein, Andreas; Kmecová, L; Egger, Jan; Pilsl, Ulrike; Zemann, Wolfgang

doi:10.1016/j.jcms.2018.04.023

Cited by 12 publications

(8 citation statements)

References 26 publications

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“…The utility of both these embalming methods can also be seen in anatomical studies concerning head and neck regions conducted on tissues previously used in the classroom. Both ethanol‐glycerin‐ (Hammer et al, 2011; Shin et al, 2016; Cotofana et al, 2017; Planitzer et al, 2017; Lee et al, 2018; Ruiz et al, 2018; Çırak et al, 2020; Siwetz et al, 2021; Jung et al, 2022) and Thiel‐ (Benkhadra et al, 2008; Pilsl & Anderhuber, 2010; Hölzle et al, 2012; Pilsl et al, 2012; Pilsl et al, 2014; Ottone et al, 2016; Pilsl et al, 2016; Bruneder et al, 2018; Bruneder et al, 2022) embalmed specimens were used successfully in macroscopic anatomy studies related to the peripheral nervous system, maxillofacial surgery, and other dental surgical interventions.…”

Section: Discussionmentioning

confidence: 99%

Undergraduate medical student perceptions and learning outcomes related to anatomy training using Thiel‐ and ethanol‐glycerin‐embalmed tissues

Antipova,

Niedermair,

Siwetz

et al. 2023

Anatomical Sciences Ed

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Anatomical dissection is known to serve as an integral tool in teaching gross anatomy, including postgraduate training. A variety of embalming techniques exist, resulting in different haptic and optical tissue properties. This study aimed to objectify learning outcomes and medical student perceptions related to the use of two widely used embalming techniques, namely Thiel and ethanol‐glycerin embalming. Between 2020 and 2022, first‐ and second‐year medical students enrolled in the course on topographic anatomy participated in this study. Objective structured practical examinations were carried out for the head, neck, thorax, abdomen, pelvis, and extremity regions following regional dissection just before the oral examinations began. Six to ten numbered tags were marked in prosections of each region in Thiel‐ and ethanol‐glycerin‐embalmed specimens. Following the examinations, the students were surveyed regarding the suitability of the two embalming techniques with respect to preservation, colorfastness, tissue pliability, and the suitability in preparing for their anatomy examinations. Consistently higher scores were achieved for the thoracic and abdominal regions in ethanol‐glycerin‐embalmed specimens when compared to Thiel. No benefit was found for Thiel‐embalmed upper or lower extremities. Tissues embalmed with ethanol‐glycerin were rated higher for preservation and suitability to achieve the learning objectives, tissue pliability was rated higher for Thiel‐embalmed tissues. Ethanol‐glycerin embalming appears to offer certain advantages for undergraduate students in recognizing visceral structures, which may align with students’ ideas on tissue suitability for their learning. Consequently, the benefits reported for Thiel embalming for postgraduate study unlikely reflect its suitability for novices.

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Section: Discussionmentioning

confidence: 99%

Undergraduate medical student perceptions and learning outcomes related to anatomy training using Thiel‐ and ethanol‐glycerin‐embalmed tissues

Antipova,

Niedermair,

Siwetz

et al. 2023

Anatomical Sciences Ed

View full text Add to dashboard Cite

show abstract

“…Blood vessels may also be twisted, and arterial thrombosis and other risk factors that affect blood supply during a therapeutic Le Fort I mobilization are observed. 29 Thus, it is important to protect the descending palatine artery on each side. To reduce the risk of vascular injury, it is necessary to accurately measure the distance between pyriform aperture rim to the descending palatine canal in the inner wall of the maxilla.…”

Section: Discussionmentioning

confidence: 99%

“…Especially in patients with cleft lip and palate, the blood supply to the palate will be less. Blood vessels may also be twisted, and arterial thrombosis and other risk factors that affect blood supply during a therapeutic Le Fort I mobilization are observed 29. Thus, it is important to protect the descending palatine artery on each side.…”

Section: Discussionmentioning

confidence: 99%

Extended Maxillary Osteotomy Guide: A Design That Allows Manipulation of the Osteotomy Direction on the Posterior and Inner Walls of the Maxilla

Wang

Lin²,

Qiao³

et al. 2022

Journal of Craniofacial Surgery

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Purpose: Design an extended osteotomy guide (EOG) for Le Fort I osteotomy to improve the safety of surgery. Materials and Methods: The digital Le Fort I osteotomy guide was designed in MIMICS 23.0. Twenty-eight patients were randomized into 2 groups. Patients in the experimental group used EOG, and patients in the control group used a traditional osteotomy guide (TOG). Virtual designs and actual postoperative outcomes were compared by cone-beam computed tomography. The safety of the operation was confirmed by the accuracy of the osteotomy direction and depth on the inner and posterior walls of the maxilla. Results: All positioning deviations of both osteotomy guides were <0.3 mm (P > 0.05). The osteotomy depths on the inner and posterior walls with the EOG and TOG deviated by 0.789 ± 1.179 and 1.811 ± 1.345 mm (P = 0.004) and 0.648 ± 0.999 and 1.262 ± 0.942 mm (P = 0.030), respectively. The angles of deviation of the osteotomy direction on the inner and posterior walls by the EOG and TOG were 2.025 ± 2.434 and 5.069 ± 2.391 degrees (P < 0.001) and 2.772 ± 2.979 and 8.653 ± 4.690 degrees (P < 0.001), respectively. Conclusions: The EOG was more accurate than TOG for manipulating osteotomy direction and depth on the inner and posterior maxillary walls. Thus, EOG could ensure higher surgical safety than TOG.

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“…A study of the risk of palatal necrosis in Le Fort I osteotomies showed that 90% of patients had normal anatomy in which both the ascending palatine and ascending pharyngeal arteries supplied the area, while 10% were dependent on the ascending pharyngeal artery alone for a blood supply to the palate. This reduction in vascular supply can pose a huge risk if the ascending pharyngeal artery is ligated in a patient with the variation, whereas in patients with normal anatomy the ascending palatine artery simply provides a supplement [2].…”

Section: Clinical Relevancementioning

confidence: 99%

Ascending palatine branch from the lingual artery with multiple other variations of the external carotid artery

et al. 2023

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show abstract

Anatomy of the Le Fort I segment: Are arterial variations a potential risk factor for avascular bone necrosis in Le Fort I osteotomies?

Cited by 12 publications

References 26 publications

Undergraduate medical student perceptions and learning outcomes related to anatomy training using Thiel‐ and ethanol‐glycerin‐embalmed tissues

Undergraduate medical student perceptions and learning outcomes related to anatomy training using Thiel‐ and ethanol‐glycerin‐embalmed tissues

Extended Maxillary Osteotomy Guide: A Design That Allows Manipulation of the Osteotomy Direction on the Posterior and Inner Walls of the Maxilla

Ascending palatine branch from the lingual artery with multiple other variations of the external carotid artery

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