Cone beam computed tomography assessment of the pterygomaxillary region and palatine canal for Le Fort I osteotomy

The aim of this study was to evaluate the anatomical linear measurements of the descending palatine canal and the pterygomaxillary fissure for Le Fort I preoperative planning. Seventy-five patients, comprising 46 females (61.3%) and 29 males (39.7%), underwent multi-slice computed tomography examinations performed for preoperative orthognathic surgical planning. The images were categorized according to sex, craniofacial side, and skeletal and craniofacial patterns. The anterior length between the descending palatine canal and the lateral wall of the piriform rim showed a higher mean value for males compared to females (P = 0.0121). The posterior distance also showed a difference between the sexes and the highest mean was observed in females (P = 0.0295). Comparing the posterior width for the skeletal patterns, a statistical difference was observed between classes I and III (P = 0.0371), and classes II and III (P = 0.0094). Regarding the craniofacial patterns, the brachycephalic (P = 0.0078) and mesocephalic (P = 0.0015) groups showed a greater posterior width in females. In conclusion, the patient's sex and aspects of the skeletal pattern and craniofacial pattern have an influence on the pterygomaxillary area and descending palatine canal anatomy. A preoperative computed tomography analysis involving this evaluation could reduce the risk of surgical complications.