Le Fort I osteotomy is a surgical procedure that can be used in adaptation of abnormally positioned jaws, skeletal malocclusions, aesthetic operations, treatment of obstructive sleep apnea, access to tumors with intracranial extensions and in other types of skull base surgery. The main problems in Le Fort I osteotomy which is performed using various techniques directed to the maxilla are intraoperative bleeding and impaired blood supply of the osteotomized segment. Results of studies evaluating the perfusion of the maxilla during and after Le Fort I osteotomy were reviewed in the present study.
Vascular events occurring during surgery should be better acknowledged in order to prevent complications such as intraoperative insufficient maxillary perfusion or postoperative bleeding. Maxillary perfusion after maxillary downfracture depends on palatal and posterior buccal soft tissue pedicles. The conclusions from previous extensive studies on maxillary blood supply after downfracture have shown that a properly performed single-segment Le Fort I osteotomy is predictable and safe. However, factors such as multisegmentalization of the maxilla, traction of the pedicle as a result of significant dentoosseous reposition, routine ligation or traction of descending palatine artery, hypotensive anesthesia, transverse laceration in the palatal soft tissues, compression, and pre-existing scar tissue adversely affect the blood flow from these pedicles to the maxillary hard and soft tissues.
As a result, it can be suggested that complications related to intraoperative and postoperative perfusion of maxilla in Le Fort I osteotomy are rare and this surgery is safe.
Key words: Le Fort I osteotomy; maxilla; perfusion
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