Maxillary sinus recovery and nasal ventilation after Le Fort I osteotomy: a prospective clinical, endoscopic, functional and radiographic evaluation

• Published in: International journal of oral and maxillofacial surgery Vol. 42; no. 11; pp. 1431 - 1436
• Main Authors: Valstar, M.H, Baas, E.M, Te Rijdt, J.P, De Bondt, B.J, Laurens, E, De Lange, J
• Format: Journal Article
• Language: English
• Published: Denmark Elsevier Ltd 01.11.2013
• Subjects: Dentistry; Endoscopy - methods; Female; Humans; Le Fort I; Male; Maxilla - surgery; Maxillary Sinus - diagnostic imaging; Maxillary Sinus - pathology; Maxillary Sinus - surgery; Nose - pathology; osteotomy; Osteotomy, Le Fort; Pilot Projects; Postoperative Complications; Prospective Studies; sinus; sinusitis; Sinusitis - diagnosis; Sinusitis - etiology; Surgery; Surveys and Questionnaires; Tomography, X-Ray Computed; ventilation; sinusitis; CT; osteotomy; sinus; ventilation; Le Fort I
• ISSN: 0901-5027; 1399-0020
• DOI: 10.1016/j.ijom.2013.05.009

Abstract The condition of the maxillary sinus is not routinely assessed before a Le Fort I osteotomy. Performing this procedure in an infected sinus might account for a considerable proportion of the complications, such as excessive bleeding and sinusitis. The aim of this study was to evaluate the maxillary sinus and nasal ventilation after Le Fort I osteotomy. Twenty patients were evaluated before and 2 months after surgery using validated questionnaires for sinonasal complaints (RSOM-31 and VAS score), nasal endoscopy, peak nasal inspiratory flow (PNIF), and a computed tomography (CT) scan. There were no differences in complaints before and 2 months after surgery ( P > 0.24). Also, the PNIF did not change significantly ( P = 0.10). On CT evaluation before surgery, a previously unnoted sinusitis was diagnosed in two patients. Postoperatively, a thickened sinus mucosa was present in all patients near the osteotomy line, the osteosyntheses, and around sequesters. This report describes maxillary sinus evaluation after Le Fort I osteotomy in a more comprehensive way by using CT. The Le Fort I procedure did not influence already existing physical or mental complaints, and nasal ventilation was not negatively affected. However, evaluation of sinonasal pathology should be emphasized in the preoperative work-up.