Bibliographic record
Abstract
A number of rare, but important, complications have been reported after Le Fort I osteotomies, including hemorrhage, cerebrovascular accidents including stroke and subarachnoid hemorrhage, carotid-cavernous sinus or other arteriovenous fistulae, false aneurysms, CSF leaks, pneumocephalus, ophthalmic complications including blindness, keratitis sicca and ophthalmoplegia, secretomotor rhinopathy, and neurosensory deafness.The cause of these complications may relate to damage to neurovascular structures from untoward fractures that extend to the base of the skull, orbit, or pterygopalatine fossa in conjunction with the pterygomaxillary dysjunction or maxillary downfracture, or from traction, compression, or contre-coup injuries to neurovascular structures from forces transmitted during the pterygomaxillary dysjunction using an osteotome or during the downfracture.These maneuvers become even more dangerous if they are traumatic in nature.The risk of complications is increased in patients with craniofacial malformations, including cleft lip and palate, or following previous midfacial trauma or orthognathic surgery.Anatomic variants, including bony defects and incomplete ossification, can occur at the base of the skull and increase the unpredictability of untoward fractures.Abnormally thick posterior maxillary walls and pterygoid plates also occur, which puts patients at increased risk.Anatomic variation of the sella tursica, sphenoid sinus, and the sphenoid bone may also be of importance.There is a close anatomical relationship between the optic canal, the greater and lesser wings of the sphenoid and the sphenoid and ethmoid sinuses.Experimental and clinical studies, including those using computed tomography scans, have looked at unusual fracture patterns after Le Fort I osteotomies.An increased incidence of high level pterygoid plate fractures at or near the base of the skull has been found when an osteotome is used to achieve the pterygomaxillary dysjunction.Alternative approaches, such as the use of a micro-oscillating saw, may make this procedure safer and reduce the occurrence of complications.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.035 | 0.017 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".