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Nasal Obstruction Evaluation After LeFort I Osteotomy: A Pilot Study.

Mychajlo S Kosyk1, Zachary D Zapatero, Christopher L Kalmar

  • 1Department of Plastic and Reconstructive Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA.

The Journal of Craniofacial Surgery
|December 30, 2021
PubMed
Summary

Distraction-mediated LeFort I osteotomy significantly improves nasal obstruction symptoms, including congestion and breathing difficulties, in Class III patients. This study highlights the positive impact of DO-LFI on quality of life related to nasal breathing.

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Otolaryngology
  • Plastic Surgery

Background:

  • Nasal obstruction is a known complication of acute LeFort I osteotomy.
  • Few studies have evaluated distraction-mediated LeFort I (DO-LFI) specifically for nasal obstruction using the NOSE scale.
  • Class III malocclusion patients often present with complex facial skeletal discrepancies impacting nasal function.

Purpose of the Study:

  • To objectively evaluate the impact of DO-LFI on nasal obstruction using the Nasal Obstruction Symptom Evaluation (NOSE) scale.
  • To assess changes in quality of life related to nasal obstruction in patients undergoing DO-LFI without concurrent intranasal surgery.
  • To identify specific components of nasal obstruction that are most affected by DO-LFI.

Main Methods:

  • Prospective pilot study involving Class III patients undergoing DO-LFI.
  • Nasal obstruction symptom evaluation (NOSE) scale administered preoperatively and postoperatively (6 months to 2 years).
  • Wilcoxon signed rank test used to compare NOSE scale scores pre- and post-surgery.

Main Results:

  • Significant improvement in composite NOSE scale scores post-DO-LFI (P < 0.017).
  • Significant improvements noted in nasal congestion/stuffiness and difficulty breathing through the nose (P < 0.017).
  • Trends towards improvement in nasal blockage and exercise-related breathing difficulty; no significant change in sleep quality.

Conclusions:

  • DO-LFI is associated with a significant reduction in patient-reported nasal obstructive symptoms.
  • DO-LFI positively impacts quality of life by improving nasal breathing.
  • Further prospective studies are needed to establish causality and explore long-term effects.