LIP-NASAL AESTHETICS FOLLOWING LE FORT-I OSTEOTOMY
LIP-NASAL AESTHETICS FOLLOWING LE FORT-I OSTEOTOMY
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DOI：
10.1097/00006534-198802000-00005
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发表时间：
1988-02-01
影响因子：
3.6
通讯作者：
ROSEN, HM
中科院分区：
文献类型：
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作者：
ROSEN, HM
我高度赞扬罗森博士努力量化与他的Le Fort I患者相关的软组织变化，将上颌骨向前和/或向上移动。然而，我觉得这个项目的方法存在一些问题。平均随访9.8个月，最短6个月。根据我的经验，通常需要至少12个月的时间才能消除所有残留的浮肿，恢复上唇的完全活动。12个月前的评估可能会在软组织变化的评估中造成微小的差异。这项研究中的一些患者可能仍在牙齿上使用正畸器具进行术后头影测量，这也可能导致在确定正畸前后软组织变化方面存在微小差异。统计分析适用于本研究，并且使用正确。然而，在一些地区评估的参数是错误的。测量方法为平行或垂直于鞍面。一个更合适的参考平面是法兰克福水平面，它通常与自然头部位置的平衡的面部结构相结合。这两条参照线之间平均有7度的差异，这可能会造成本研究中使用的测量结果的差异。这项研究的一个重要问题是，在评估上颌前移的30名患者中，只有13人有直接的上颌前移。12例患者有较好的复位和前进，5例患者有较差的复位和前进。这三种不同的手术方式对软组织改变有不同的影响。
I commend Dr. Rosen highly for his efforts to quantify the soft-tissue changes associated with his Le Fort I patients, moving the maxilla superiorly and/or anteriorly. However, I feel that there are some problems with the methodology of this project. The average follow-up was 9.8 months, with a minimum of 6 months. In my experience, it frequently takes at least 12 months before all residual edema has dissipated and complete animation of the upper lip has returned. Evaluation prior to 12 months may cause minor discrepancies in the evaluation of soft-tissue changes. Some of the patients in this study may still have had orthodontic appliances on their teeth for the postoperative cephalograms, which also may cause minor discrepancies in the determination of anteroposterior soft-tissue changes. The statistical analyses are appropriate for this study and were used correctly. However, the parameters evaluated in some areas were erroneous. Measurements were made either parallel or perpendicular to the sella-nasion plane. A more appropriate plane of reference is the Frankfort horizontal plane, which more commonly co-incides with a well-balanced facial structure in a natural head position. There is a 7 degree difference, on average, between these two reference lines, and this can create discrepancies with regard to measurements used in this study. One significant problem with this study is that in the group of 30 patients evaluated for maxillary advancement, only 13 had straightforward maxillary advancements. Twelve patients had superior repositioning as well as advancement, and 5 had inferior repositioning as well as advancement. These three different surgical procedures have different effects on soft-tissue changes of