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Does Le Fort I Osteotomy Influence Nasal Septum Deviation?

Canay Yılmaz Asan1, Ebru Baydan2, Mehmet Amuk3

  • 1Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Erciyes University, Kayseri, Turkey.

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
|July 28, 2023
PubMed
Summary

Le Fort I osteotomy can alter nasal appearance by affecting the nasal septum. Maxillary advancement and impaction movements significantly increase the risk of postoperative septal angle changes.

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Orthognathic Surgery
  • Craniofacial Anatomy

Background:

  • Le Fort I osteotomy surgically repositions the maxilla.
  • Close anatomical proximity exists between the maxilla and nasal structures.
  • Maxillary repositioning may impact the nasal septum and surrounding tissues.

Purpose of the Study:

  • To investigate the effects of maxillary movements on the nasal septum post-Le Fort I osteotomy.
  • To analyze changes in the nasal septal angle using cone-beam computed tomography (CBCT).
  • To test the hypothesis that maxillary impaction and advancement influence septal angle.

Main Methods:

  • Retrospective cohort study of 77 patients undergoing Le Fort I osteotomy.
  • CBCT imaging preoperatively (T0) and postoperatively (T1, ≥12 months).
  • Analysis of nasal septal angle changes, correlating with maxillary vertical and horizontal movements.

Main Results:

  • A significant increase in the average nasal septum angle was observed postoperatively (P = .031).
  • Septal angle decreased in 28% of patients.
  • Combined maxillary advancement and impaction led to a higher rate of postoperative angular change (P = .014).

Conclusions:

  • Le Fort I osteotomies are associated with changes in nasal appearance.
  • Septal deviation can occur in up to 37% of cases following this procedure.
  • Understanding these changes is crucial for surgical planning and patient outcomes.