Study of Anatomical Changes of the Inferior Nasal Passage After Le Fort I Osteotomy With Superior Repositioning

Notably, many studies have focused on the bony interference in the maxillary segment when performing maxillary superior repositioning; however, few reports have described the interference with the inferior nasal turbinate. Therefore, the authors aimed to retrospectively analyze the soft tissue or bone tissue volume of the inferior nasal turbinate and the accuracy of maxillary superior repositioning in Le Fort I osteotomy (LF1). The authors included 83 patients with facial deformities who underwent conventional LF1 (maxillary molar elevation between 4.0 and 6.0 mm) with/without bilateral sagittal split ramus osteotomy. The ratio of the soft tissue of the inferior turbinate to that of the inferior nasal cavity was used to divide the participants into 2 subgroups (large and small ratio). Similarly, the bony tissue volume of the inferior turbinate was used to divide the participants into 2 subgroups (large and small bony tissues), and the planned or actual amount of superior repositioning was compared 3 dimensionally. In the soft tissue group, the subgroups showed no significant differences (P=0.934). However, the actual maxillary superior repositioning was significantly lower in the large bone group than in the planned maxillary elevation group (P<0.01). In cases where the maxillary molar needs to be elevated by >4 mm and the bone tissue of the inferior nasal turbinate is well developed, an adjunctive technique such as horseshoe osteotomy or partial inferior turbinate resection should be considered in addition to LF1 to avoid interference between the inferior nasal turbinate and the maxillary bone fragments.

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Factors affecting postoperative nasal morphology after Le FortⅠosteotomy on multiple regression analysis

TOMOMATSU,

Nakamura,

Matsumoto

et al. 2024

Preprint

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External nasal morphology changes after LeFort I osteotomy, and various techniques including alar cinch suture, and subspinal osteotomy have been devised to accommodate these changes. However, despite various modifications, external nasal morphology may vary unexpectedly on an individual basis. Considering that the patient's external nasal morphology may be a contributing factor, this paper reports a retrospective study of the surgical technique and direction of maxillary movement in addition to the measurement of factors that comprise the external nasal morphology. Multiple regression analysis identified the patient's preoperative nasal width as a factor that increased the alar base width of the nose, in addition to the incision (oral vestibular incision) and the amount of anterior and superior movements at point A of the maxilla. The factors that caused the nasal apex to turn upward were the amount of anterior and superior movements at point A and the absence of subspinal osteotomy. The direction of surgical maxillary movement was influenced not only by anterior movement, but also by superior movement and surgical technique. Furthermore, the patient's preoperative nasal morphology was taken into consideration in determining the preoperative mode of movement.

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Study of Anatomical Changes of the Inferior Nasal Passage After Le Fort I Osteotomy With Superior Repositioning

Cited by 3 publications

References 27 publications

Morphological changes in the inferior nasal passage associated with superior repositioning of the maxilla with/without horseshoe osteotomy or turbinectomy

Morphological changes in the inferior nasal passage associated with superior repositioning of the maxilla with/without horseshoe osteotomy or turbinectomy

Influence of the Inferior Turbinate on the Accuracy of Superior Maxillary Repositioning

Factors affecting postoperative nasal morphology after Le FortⅠosteotomy on multiple regression analysis

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