Study of Anatomical Changes of the Inferior Nasal Passage After Le Fort I Osteotomy With Superior Repositioning.
Journal
The Journal of craniofacial surgery
ISSN: 1536-3732
Titre abrégé: J Craniofac Surg
Pays: United States
ID NLM: 9010410
Informations de publication
Date de publication:
01 Oct 2023
01 Oct 2023
Historique:
received:
08
05
2023
accepted:
04
06
2023
medline:
1
11
2023
pubmed:
6
10
2023
entrez:
6
10
2023
Statut:
ppublish
Résumé
The relationship between postoperative morphological changes in the inferior nasal cavity and inferior turbinate after Le Fort I osteotomy remains unclear. This study aimed to investigate how the bone volume of the inferior turbinate affects contact with the inferior nasal cavity of patients who underwent superior repositioning. We evaluated the 3-dimensional relationship between the anatomical changes in the inferior nasal passage before and after surgery in 51 patients who underwent Le Fort I osteotomy with an elevation of >4.0 mm in the first molar. The soft tissue and bone volumes of the inferior turbinate and airway volume of the inferior nasal passage were calculated using Proplan CMF 3.0 and compared according to the size of the bone volume of the inferior turbinate. In addition, we reclassified the maxillary movements in the pitch direction and compared the results. The contact rates of the postoperative inferior nasal airway and the inferior turbinate in the large-bone group was 72.3% and that in the small-bone group was 40.0% in the χ2 test. The reduction in the inferior nasal passage volume was significantly greater in the large-bone group (pitch+) than in the small-bone group (pitch+). For patients with well-developed bony tissue of the inferior turbinate, caution is advised if the maxillary elevation is ≥4.0 mm, because the possibility of postoperative obstruction of the inferior nasal passages exist, which may lead to deterioration of nasal ventilation.
Identifiants
pubmed: 37801719
doi: 10.1097/SCS.0000000000009585
pii: 00001665-202310000-00103
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e678-e682Informations de copyright
Copyright © 2023 by Mutaz B. Habal, MD.
Déclaration de conflit d'intérêts
The authors report no conflicts of interest.
Références
Kramer FJ, Baethge C, Swennen G, et al. Intra-and perioperative complications of the LeFort1 osteotomy: a prospective evaluation of 1000 patients. J Craniofac Surg 2004;15:971–977
Okushi T, Tonogi M, Arisaka T, et al. Effect of maxillomandibular advancement on morphology of velopharyngeal space. J Oral Maxillofac Surg 2011;69:877–884
Jang SI, Ahn J, Paeng JY, et al. Three-dimensional analysis of changes in airway space after bimaxillary orthognathic surgery with maxillomandibular setback and their association with obstructive sleep apnea. Maxillofac Plast Reconstr Surg 2018;40:33
Nomura T, Sasaki A, Fujimoto M, et al. Effects of jaw movement in bimaxillary orthognathic surgery on the upper airway: computational fluid dynamics analysis. Orthod Craniofac Res 2023;26:311–319
Shirazawa Y, Iwasaki T, Ooi K, et al. Relationship between pharyngeal airway depth and ventilation condition in mandibular setback surgery: a computational fluid dynamics study. Orthod Craniofac Res 2020;23:313–322
Posnick JC, Fantuzzo JJ, Troost T. Simultaneous intranasal procedures to improve chronic obstructive nasal breathing in patients undergoing maxillary (Le Fort I) osteotomy. J Oral Maxillofac Surg 2007;65:2273–2281
Erbe M, Lehotay M, Göde U, et al. Nasal airway changes after Le Fort I-impaction and advancement: anatomical and functional findings. Int J Oral Maxillofac Surg 2001;30:123–129
Walker DA, Turvey TA, Warren DW. Alterations in nasal respiration and nasal airway size following superior repositioning of the maxilla. J Oral Maxillofac Surg 1988;46:276–281
Haarmann S, Budihardja AS, Wolff KD, et al. Changes in acoustic airway profiles and nasal airway resistance after Le Fort I osteotomy and functional rhinosurgery: a prospective study. Int J Oral Maxillofac Surg 2009;38:321–325
Pourdanesh F, Sharifi R, Mohebbi A, et al. Effects of maxillary advancement and impaction on nasal airway function. Int J Oral Maxillofac Surg 2012;41:1350–1352
Posnick JC, Choi E, Adachie A, et al. Correction of symptomatic chronic nasal airway obstruction in conjunction with bimaxillary orthognathic surgery: does it complicate recovery and is it effective? J Oral Maxillofac Surg 2016;74:620.e1–620.e11
Bell WH, Sinn DP. Turbinectomy to facilitate superior movement of the maxilla by Le Fort I osteotomy. J Oral Surg 1979;37:129–130
Mirmohamadsadeghi H, Zanganeh R, Barati B, et al. Does maxillary superior repositioning affect nasal airway function? Br J Oral Maxillofac Surg 2020;58:807–811
Tsutsui T, Moroi A, Yoshizawa K, et al. Evaluation of nasal function and upper airway morphology after bi-maxillary surgery using rhinomanometry and computed tomography. J Craniofac Surg 2022;33:214–218
Pellby D, Bengtsson M. Changes in the upper airway volume after orthognathic surgery: three-dimensional measurements in a supine body position. Int J Oral Maxillofac Surg 2022;22:462–463
Ueki K, Takayama A, Moroi A, et al. Computed tomography assessment of maxillary sinus and inferior nasal airway after Le Fort I osteotomy. J Craniofac Surg 2022;33:1835–1839
Koç O, Tüz HH. Effect of maxillary surgical movement on nasal cavity and maxillary sinus dimensions and function after Le Fort I osteotomy. Int J Oral Maxillofac Surg 2022;51:806–812
Tomomatsu N, Takahara N, Nakakuki K, et al. Study of morphological changes in the inferior turbinate after Le Fort I osteotomy. J Craniofac Surg 2022;33:e741–e744
Epker BN, Schendel SA. Total maxillary surgery. Int J Oral Surg 1980;9:1–24
Movahed R, Morales-Ryan C, Allen WR, et al. Outcome assessment of 603 cases of concomitant inferior turbinectomy and Le Fort I osteotomy. Proc (Bayl Univ Med Cent) 2013;26:376–381
Inthavong K, Chetty A, Shang Y, et al. Examining mesh independence for flow dynamics in the human nasal cavity. Comput Biol Med 2018;102:40–50
Harada K, Sumida E, Enomoto S, et al. Post-operative stability of the maxilla treated with Le Fort I and horseshoe osteotomies in bimaxillary surgery. Eur J Orthod 2002;24:471–476
Yoshioka I, Khanal A, Kodama M, et al. Postoperative skeletal stability and accuracy of a new combined Le Fort I and horseshoe osteotomy for superior repositioning of the maxilla. Int J Oral Maxillofac Surg 2009;38:1250–1255
Demas PN, Sotereanos GC. Incidence of nasolacrimal injury and turbinectomy-associated atrophic rhinitis with Le Fort I osteotomies. J Craniomaxillofac Surg 1989;17:116–118
Scheithauer MO. Surgery of the turbinates and “empty nose” syndrome. GMS Curr Top Otorhinolaryngol Head Neck Surg 2010;9:Doc03
Kita S, Oshima M, Shimazaki K, et al. Computational fluid dynamic study of nasal respiratory function before and after bimaxillary orthognathic surgery with bone trimming at the inferior edge of the pyriform aperture. J Oral Maxillofac Surg 2016;74:2241–2251
Aoyagi M, Oshima M, Oishi M, et al. Computational fluid dynamic analysis of the nasal respiratory function before and after postero-superior repositioning of the maxilla. PLoS ONE 2022;17:e0267677
Zhu JH, Lee HP, Lim KM, et al. Evaluation and comparison of nasal airway flow patterns among three subjects from Caucasian, Chinese and Indian ethnic groups using computational fluid dynamics simulation. Respir Physiol Neurobiol 2011;175:62–69
Pendolino AL, Scarpa B, Ottaviano G. Relationship between nasal cycle, nasal symptoms and nasal cytology. Am J Rhinol Allergy 2019;33:644–649