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Is Le Fort I Osteotomy Associated With Maxillary Sinusitis?
Pier Francesco Nocini1, Antonio D'Agostino2, Lorenzo Trevisiol2
1Professor and Chief, Section of Oral and Maxillofacial Surgery, Department of Surgery, University of Verona, Verona, Italy.
Summary
Le Fort I osteotomy can negatively impact maxillary sinus health, leading to increased sinusitis symptoms and inflammatory changes. Postoperative monitoring with cone beam computed tomography (CBCT) scans and Sino-Nasal Outcome 20-item Test (SNOT-20) is recommended.
Area of Science:
- Oral and Maxillofacial Surgery
- Otolaryngology
- Radiology
Background:
- Le Fort I osteotomy is a surgical procedure used to correct midface deformities.
- Potential effects on the maxillary sinus anatomy and health are not fully understood.
Purpose of the Study:
- To investigate the association between Le Fort I osteotomy and changes in the maxillary sinus.
- To evaluate anatomic, radiologic, and symptomatic modifications post-surgery.
Main Methods:
- Retrospective cohort study of 64 patients who underwent Le Fort I osteotomy.
- Pre- and postoperative cone beam computed tomography (CBCT) scans were analyzed.
- Sino-Nasal Outcome 20-item Test (SNOT-20) assessed rhinosinusitis symptoms.
Main Results:
- Significant increase in rhinosinusitis symptoms (SNOT scores) and radiologic evidence of inflammation (Lund-Mackay scores) post-surgery.
- 19% decrease in mean sinus volume and 37% incidence of iatrogenic injury observed.
- Preoperative sinusitis symptoms were present in 3.1% of patients, increasing to 17.2% postoperatively.
Conclusions:
- Le Fort I osteotomy significantly impacts maxillary sinus health, causing inflammation and symptoms.
- Routine postoperative monitoring using CBCT and SNOT-20 is advised.
- Further long-term studies are needed to fully elucidate outcomes and complications.
