Computed Tomography Scan Assessment of the Anatomy of the Pterygomaxillary Junction and Its Relevance in Le Fort I Osteotomy

Abstract

Knowledge of the morphometry and types of pterygomaxillary junction (PMJ) during Le-Fort I osteotomy is an important consideration in the reduction of intraoperative complications. The PMJ is known to display population variations and with the recent increase in these surgical interventions in Kenya, a detailed description of the PMJ is warranted. Computed tomography scan images of PMJ obtained from 63 patients were analyzed at the level of the posterior nasal spine to assess types and the morphometry of the PMJ. A fissure type of PMJ was present in 65.9% (83/126 sides) while a synostosis type was present in 34.1% (43/126). Bilateral fissures were found in 58.73% (37/63), bilateral synostosis in 26.98% (17/63), and an asymmetric PMJ in 15.25% (9/63). The average height, width, and thickness of the PMJ were 17.45 ± 5.26 mm, 10.24 ± 1.97 mm, and 6.40 ± 1.97 mm respectively. Males had a significantly greater height (P = 0.003) and width (P = 0.000). The average width was greater in cases with a synostosis as compared with those with a fissure (P = 0.019). Average distance of greater palatine canal was 40.41 ± 2.28 mm and 7.19 ± 2.20 mm from the piriform rim and the pterygoid fossa respectively. The PMJ among Kenyans is characterized by a higher occurrence of synostosis, greater height, and thickness compared with previous findings from other populations. The results of this study can be helpful for surgeons in selecting the most appropriate techniques to achieve successful pterygomaxillary disjunction and minimize avoid attendant complications such as vascular and nerve injuries.

An Innovative Approach for Maxillary Mobilization: Technique and a Case Report

“…Untoward fractures may be propagated from a Le Fort I procedure, mainly resulting from pterygomaxillary dysfunction and maxillary down fracture. Such fracture patterns have been extensively assessed in radiological, cadaveric, and dry skull studies [7,8,9].…”

The Anatomy, Features and Sex Correlations (Dimorphism) of Tubero–Palato–Pterygoid Region among Adult Population—Single Center Study Based on 3D Printed Models

“…Numerous scholars posit that knowledge relating to the morphometry of the tuberopalato-pterygoid region can be helpful to surgeons during surgical treatment (e.g., LeFort I osteotomy procedure) and is an important consideration in the reduction of intraoperative complications [12,13]. Data relating to the physical measurements of the pterygomaxillary region is required by clinicians for pterygoid implant placement, for example [13].…”