MAXILLARY PERFUSION DURING LE-FORT-I OSTEOTOMY AFTER LIGATION OF THE DESCENDING PALATINE ARTERY

Purpose: Controversy exists regarding management of the descending pal atine artery (DPA) during Le Fort I osteotomy. Some surgeons advocate preserving the DPA, and others ligate the vessels. The purpose of this study was to evaluate maxillary gingival blood flow (GBF) during Le F ort I osteotomy in a sample of patients with and without ligation of t he DPA. Patients and Methods: Using a prospective randomized clinical study, we enrolled a study sample composed of 34 patients undergoing L e Fort I osteotomy. The patients were randomly assigned to either stud y group 1 (IG)(DPA ligated) or group 2 (18) (DPA preserved). To measur e maxillary GBF during the operation, we used laser Doppler flowmetry (LDF). The predictor variable was status of DPA management (ligated or preserved). The outcome variable was change in GBF over time. Results : (DPA). Before ligation (or simulated ligation) of the DPA, the mean GBF for groups 1 and 2 was 11.4 +/- 8.6 and 11.9 +/- 9.4 mL/min/100 g tissue, respectively (P = .88). After ligation of the DPA in group 1, the mean GBF was 10.0 +/- 7.7 mL/min/100 g tissue. At the correspondin g time in group 2 (DPA preserved), the mean GBF was 12.6 +/- 9.4 mL/mi n/100 g tissue. The difference in mean GBF between groups 1 and 2 was not statistically significant (P = .43). Conclusion: There were no sta tistically significant differences in mean maxillary GBF between patie nts having the DPA ligated and those having the DPA preserved as measu red using LDF during Le Fort I osteotomy.