Dt. Lanigan et P. Guest, ALTERNATIVE APPROACHES TO PTERYGOMAXILLARY SEPARATION, International journal of oral and maxillofacial surgery, 22(3), 1993, pp. 131-138
Pterygoid plate fractures, resulting from the pterygomaxillary separat
ion in a Le Fort I osteotomy, may be associated with untoward fracture
s that extend to the base of the skull and orbit and which can lead to
rare but significant complications. Five alternative approaches to th
e pterygomaxillary dysjunction were studied in 50 fresh cadavers. The
results of this study show that the use of a curved Obwegeser osteotom
e to achieve the pterygomaxillary dysjunction should be abandoned, as
it leads to an unacceptably high incidence of high-level pterygoid pla
te fractures at, or near, the base of the skull. The best results were
obtained with a Stryker(R) micro-oscillating saw.