Subnasal modified Le Fort I osteotomy: indications and results

Area of Science:

• Oral and Maxillofacial Surgery
• Orthognathic Surgery
• Facial Plastic Surgery

Background:

• Class III dentofacial deformities often require maxillary advancement.
• Conventional Le Fort I osteotomy may be limited by nasal tip projection.
• Subnasal modified Le Fort I osteotomy offers an alternative for maxillary advancement.

Purpose of the Study:

• To evaluate morphologic changes in the nose following subnasal modified Le Fort I osteotomy.
• To assess the impact of this procedure on nasal soft tissues in patients with normal preoperative nasal morphology.
• To determine the stability of nasal changes post-surgery.

Main Methods:

• Prospective study of 15 patients (mean age 26.2 years) with Class III deformities.
• Subnasal modified Le Fort I osteotomy performed for maxillary advancement (mean 7.5 mm).
• Lateral cephalograms, CT-3D, and clinical analysis of nasal width, tip protrusion, and bridge length at 3 time points (preoperative, 6 months, 12 months post-surgery).

Main Results:

• No significant changes were observed in alar/nose base width, nasal tip protrusion, or nasal bridge length post-surgery.
• No significant differences were found between measurements at 6 and 12 months post-surgery.
• No significant complications were reported.

Conclusions:

• Subnasal modified Le Fort I osteotomy is effective in correcting Class III dentofacial deformities.
• This surgical technique prevents undesirable soft tissue changes in the nose.
• The procedure yields stable nasal morphology in patients with normal preoperative nasal form.