Skip to main content
SpringerLink
Log in

Assessment of Nasal Septum Change after Le Fort I Osteotomy Using Cone Beam Computed Tomography

  • ORIGINAL ARTICLE
  • Published:
Journal of Maxillofacial and Oral Surgery Aims and scope Submit manuscript

Abstract

Objective

Le Fort I osteotomy (LF-IO) is widely used for the correction of dentofacial deformities, which may cause changes in the postoperative nasal septum (NS). The objective of this study was to evaluate the effects of LF-IO on the NS deviation and to determine whether the NS was affected by differences in the direction of maxilla movement.

Materials and Methods

A retrospective study including 57 patients who underwent LF-IO and received cone beam computed tomography (CBCT) preoperatively and 6–12 months postoperative evaluation was performed. The NS angle of each patient was measured both pre- and postoperatively in the two coronal sections (nasion and ostium levels). The patients were divided into five paired groups and calculated. Group 1 to 4 were divided depending on the differences in the direction of maxilla movement (Group 1. Impaction ≥ 5 mm vs. Impaction < 5 mm; Group 2. Anterior movement vs. Non-anterior movement; Group 3. Impaction symmetry vs. Impaction asymmetry; and Group 4. Impaction vs. Inferior repositioning). Group 5 was divided as One-piece osteotomy vs. Multi-segmental osteotomy.

Results

The mean NS angles at both nasion and ostium levels of all patients were significant increased after LF-IO. However, there were no statistical significant differences of the five paired groups.

Conclusions

LF-IO osteotomy influenced increasing of the NS deviation at both the nasion and ostium levels. However, differences in the direction of the maxilla movement and maxilla segmentation showed no statistically significant changes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Haarmann S et al (2009) 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 38:321–325

    Article  CAS  PubMed  Google Scholar 

  2. Buchanan EP, Hyman CH (2013) Le Fort I osteotomy. Semin Plast Surg 27(3):149–154

    Article  PubMed  PubMed Central  Google Scholar 

  3. On SW, Baek SH, Choi JY (2020) Quantitative evaluation of the postoperative changes in nasal septal deviation by diverse movement of the maxilla after Le Fort I osteotomy. J Craniofac Surg 31(5):1251–1255

    Article  PubMed  Google Scholar 

  4. O’Ryan F, Schendel S (1989) Nasal anatomy and maxillary surgery. II. Unfavorable nasolabial esthetics following the Le Fort I osteotomy. Int J Adult Orthodon Orthognath Surg, 4:75–84

  5. Krennmair G, Ulm C, Lugmayr H (1997) Maxillary sinus septa: incidence, morphology and clinical implications. J Craniomaxillofac Surg 25:261–265

    Article  CAS  PubMed  Google Scholar 

  6. Harris D et al (2012) EAO guidelines for the use of diagnostic imaging in implant dentistry 2011. A consensus workshop organized by the European association for osseointegration at the medical university of Warsaw. Clin Oral Implants Res 23(11):1243–1253

    Article  PubMed  Google Scholar 

  7. Rancitelli D et al (2015) Maxillary sinus septa and anatomic correlation with the schneiderian membrane. J Craniofac Surg 26(4):1394–1398

    Article  PubMed  Google Scholar 

  8. Rahpeyma A, Khajehahmadi S (2014) Alveolar antral artery: review of surgical techniques involving this anatomic structure. Iran J Otorhinolaryngol 26:73–77

    PubMed  PubMed Central  Google Scholar 

  9. Nocini PF et al (2016) Is Le Fort I osteotomy associated with maxillary sinusitis? J Oral Maxillofac Surg 74(2):400.e1-400.e12

    Article  PubMed  Google Scholar 

  10. Valstar MH et al (2013) Maxillary sinus recovery and nasal ventilation after Le Fort I osteotomy: a prospective clinical, endoscopic, functional and radiographic evaluation. Int J Oral Maxillofac Surg 42(11):1431–1436

    Article  CAS  PubMed  Google Scholar 

  11. Kramer FJ et al (2004) Intra- and perioperative complications of the Le Fort I osteotomy: a prospective evaluation of 1000 patients. J Craniofac Surg 15(6):971–977

    Article  PubMed  Google Scholar 

  12. Posnick JC, Fantuzzo JJ, Troost T (2007) Simultaneous intranasal procedures to improve chronic obstructive nasal breathing in patients undergoing maxillary (le fort I) osteotomy. J Oral Maxillofac Surg 65:2273–2281

    Article  PubMed  Google Scholar 

  13. Acebal-Bianco F et al (2000) Perioperative complications in corrective facial orthopedic surgery: a 5-year retrospective study. J Oral Maxillofac Surg 58(7):754–760

    Article  CAS  PubMed  Google Scholar 

  14. Nyárády Z et al (2006) Submental endotracheal intubation in concurrent orthognathic surgery: a technical note. J Craniomaxillofac Surg 34(6):362–365

    Article  PubMed  Google Scholar 

  15. Chandu A, Witherow H, Stewart A (2008) Submental intubation in orthognathic surgery: initial experience. Br J Oral Maxillofac Surg 46:561–563

    Article  PubMed  Google Scholar 

  16. Moroi A et al (2016) Assessment of nasal septum after Le Fort I osteotomy with computer tomography. J Craniomaxillofac Surg 44(9):1187–1193

    Article  PubMed  Google Scholar 

  17. Baeg SW et al (2018) Evaluation of sinonasal change after Le Fort I osteotomy using cone beam computed tomography images. J Craniofac Surg 29(1):e34–e41

    Article  PubMed  Google Scholar 

  18. Mladina R et al (2008) Nasal septal deformities in ear, nose, and throat patients: an international study. Am J Otolaryngol 29(2):75–82

    Article  PubMed  Google Scholar 

  19. Jin HR, Lee JY, Jung WJ (2007) New description method and classification system for septal deviation. J Rhinol 14(1):27–31

    Google Scholar 

  20. Stallman JS, Lobo JN, Som PM (2004) The incidence of concha bullosa and its relationship to nasal septal deviation and paranasal sinus disease. AJNR Am J Neuroradiol 25(9):1613–1618

    PubMed  PubMed Central  Google Scholar 

  21. Balikci HH et al (2016) Relationships among concha bullosa, nasal septal deviation, and sinusitis: Retrospective analysis of 296 cases. Ear Nose Throat J 95(12):487–491

    Article  PubMed  Google Scholar 

  22. Lerdlum S, Vachiranubhap B (2005) Prevalence of anatomic variation demonstrated on screening sinus computed tomography and clinical correlation. J Med Assoc Thai 88(4):S110-115

    PubMed  Google Scholar 

  23. Kaygusuz A et al (2014) Sinonasal anatomical variations: their relationship with chronic rhinosinusitis and effect on the severity of disease-a computerized tomography assisted anatomical and clinical study. Indian J Otolaryngol Head Neck Surg 66(3):260–226

    Article  PubMed  Google Scholar 

  24. Kucybała I et al (2017) Nasal septal deviation and concha bullosa - Do they have an impact on maxillary sinus volumes and prevalence of maxillary sinusitis? Pol J Radiol 82:126–133

    Article  PubMed  PubMed Central  Google Scholar 

  25. Erbe M et al (2001) Nasal airway changes after Le Fort I—impaction and advancement: anatomical and functional findings. Int J Oral Maxillofac Surg 30(2):123–129

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

None.

Author information

Authors and Affiliations

  1. Dental Division, Royal Thai Air Force Hospital, 555 Decha Tungkha Road, Si Kan, Don Mueang, Bangkok, 10210, Thailand

    Pornpop Rattana-arpha

  2. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, 6 Yothi Street, Ratchathewi, Bangkok, 10400, Thailand

    Kiatanant Boonsiriseth & Yutthasak Kriangcherdsak

  3. Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Mahidol University, 6 Yothi Street, Ratchathewi, Bangkok, 10400, Thailand

    Kornkamol Kretapirom

Authors
  1. Pornpop Rattana-arpha
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kiatanant Boonsiriseth
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kornkamol Kretapirom
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yutthasak Kriangcherdsak
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kiatanant Boonsiriseth.

Ethics declarations

Conflict of interest

The authors declared that they have no conflict of interest.

Ethical approval

This study was approved by Faculty of Dentistry/Faculty of Pharmacy, Mahidol University, institutional Review Board (COA.No.MU-DT/PY-IRB 2021/099.2812).

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rattana-arpha, P., Boonsiriseth, K., Kretapirom, K. et al. Assessment of Nasal Septum Change after Le Fort I Osteotomy Using Cone Beam Computed Tomography. J. Maxillofac. Oral Surg. 22, 799–805 (2023). https://doi.org/10.1007/s12663-023-02058-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12663-023-02058-4

Keywords

Search

Navigation