Impact of Le-Fort I osteotomy on anatomical and functional aspects of the nasal airway and on quality of life

Eur Arch Otorhinolaryngol. 2019 Apr;276(4):1065-1073. doi: 10.1007/s00405-018-05277-5. Epub 2019 Jan 14.

Abstract

Objectives: Orthognathic surgery is a well-established procedure for skeletal deformities. Beneficial influences to the posterior airway space (PAS) have been described, but little is known about the subjective aesthetical and functional nasal aspects after orthognathic surgery. The aim of this study was to evaluate nasal airflow by anterior rhinomanometry and volumetric changes in the nasal airway space after mono- or bimaxillary surgery using cone-beam computed tomography (CBCT) and a new segmentation software. Furthermore, changes of patient's quality of life (QoL) should be assessed.

Methods: Ten patients (9 skeletal class malformation III, 1 skeletal class malformation I) were included. CBCT images, rhinological inspections and anterior rhinomanometries were performed before (T0) and after surgery (T1). All patients completed the FROI-17, the ROE and the SF-36 questionnaires.

Results: A significant postoperative gain for nasal airway volume compared with the baseline was shown (p < 0.014). No statistically significant differences between pre- and postoperative flow rates were found (p = 0.114). Pre- and postoperative cohorts did not differ in responses of disease-specific (ROE and FROI-17) and generic QoL questionnaires (SF-36).

Conclusion: Maxillary relocation surgery leads to a significant increase in nasal airway space. Subjectively, orthognathic patients did not experience any functional but psychosocial aspects after bimaxillary surgery.

Keywords: Le Fort-I-osteotomy; Nasal airway space; Orthognathic surgery; Quality of life; Rhinomanometry.

MeSH terms

  • Adult
  • Cone-Beam Computed Tomography / methods
  • Facial Bones / abnormalities
  • Facial Bones / diagnostic imaging
  • Female
  • Follow-Up Studies
  • Humans
  • Imaging, Three-Dimensional / methods
  • Male
  • Maxilla* / diagnostic imaging
  • Maxilla* / surgery
  • Nasal Obstruction* / diagnosis
  • Nasal Obstruction* / etiology
  • Nasal Obstruction* / psychology
  • Orthognathic Surgical Procedures / methods
  • Osteotomy, Le Fort* / adverse effects
  • Osteotomy, Le Fort* / methods
  • Osteotomy, Sagittal Split Ramus
  • Postoperative Period
  • Quality of Life*
  • Rhinomanometry / methods