Does Le Fort I osteotomy have an influence on nasal cavity and septum deviation?

Niger J Clin Pract. 2020 Feb;23(2):240-245. doi: 10.4103/njcp.njcp_355_19.

Abstract

Aims: Le Fort I (LI) osteotomy has been used for the correction of dento-facial deformities of the midface. The aim of this study was to determine the effects of advancement and impaction of the maxilla with LI osteotomy on the nasal cavity and septum.

Patients and methods: In this study, 40 adult patients, 23 females and 17 males (mean age 20.52 ± 4.4 years), who underwent single-piece LI advancement and impaction surgery combined with a bilateral sagittal split osteotomy (BSSO) were included. Posterior-anterior (PA) and lateral cephalometric radiographs taken before surgery (T0) and at least three months after surgery (T1) were evaluated. The superior and anterior movements of maxilla, changes of the nasal cavity, nasal septum and maxillo-mandibular parameter were measured on the cephalometric radiographs. Treatment changes were statistically analyzed using paired sample t-test, and Pearson correlation analysis was applied for the determination of the relationship between variables.

Results: There was no statistically significant change in the deviation parameters (P > 0,05). However, a statistically significant decrease was found for left and right nasal cavity heights after LI osteotomy (P < 0.05). Furthermore, no significant correlation was found between septal deviation angle and extent of maxillary movement (P > 0.05). Positive correlation was found between nasal cavity width and amount of maxillary impaction. (P < 0.05).

Conclusion: The influence of maxillary impaction with LI osteotomy on nasal septum deviation was not found significant but maxillary impaction with LI osteotomy significantly increased the nasal cavity width.

Keywords: Le Fort I osteotomy; maxillofacial surgery; nasal cavity; nasal septum; orthognathic surgery.

MeSH terms

  • Adolescent
  • Female
  • Humans
  • Male
  • Mandible / surgery*
  • Maxilla / surgery*
  • Nasal Cavity
  • Nasal Septum / diagnostic imaging*
  • Nasal Septum / surgery
  • Nose Deformities, Acquired / etiology*
  • Orthognathic Surgery / methods*
  • Osteotomy, Le Fort / adverse effects
  • Osteotomy, Le Fort / methods*
  • Postoperative Complications*
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Young Adult