NDLI: Is Le Fort I Osteotomy Associated With Maxillary Sinusitis?

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Is Le Fort I Osteotomy Associated With Maxillary Sinusitis?

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Is Le Fort I Osteotomy Associated With Maxillary Sinusitis?

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Nocini, Pier Francesco D'Agostino, Antonio Trevisiol, Lorenzo Favero, Vittorio Pessina, Mattia Procacci, Pasquale
Description	Country affiliation: Italy Author Affiliation: Nocini PF ( Professor and Chief, Section of Oral and Maxillofacial Surgery, Department of Surgery, University of Verona, Verona, Italy.); D'Agostino A ( Associate Professor, Section of Oral and Maxillofacial Surgery, Department of Surgery, University of Verona, Verona, Italy.); Trevisiol L ( Associate Professor, Section of Oral and Maxillofacial Surgery, Department of Surgery, University of Verona, Verona, Italy. Electronic address: lorenzo.trevisiol@univr.it.); Favero V ( Maxillo-Facial Surgeon, Section of Oral and Maxillofacial Surgery, Department of Surgery, University of Verona, Verona, Italy.); Pessina M ( Maxillo-Facial Surgeon, Section of Oral and Maxillofacial Surgery, Department of Surgery, University of Verona, Verona, Italy.); Procacci P ( Assistant Professor, Section of Oral and Maxillofacial Surgery, Department of Surgery, University of Verona, Verona, Italy.)
Abstract	PURPOSE: The purpose of the present study was to investigate the association between Le Fort I osteotomy and the anatomic, radiologic, and symptomatic modifications of the maxillary sinus. MATERIALS AND METHODS: Subjects who had undergone Le Fort I osteotomy from January 2008 to December 2013 were enrolled in a retrospective cohort study. The eligibility criteria were the availability of a cone beam computed tomography (CBCT) scan taken before and 12 to 24 months after the procedure. The exclusion criteria were the unavailability of CBCT scans, the use of tobacco, and previous orthognathic procedures. The primary predictor variable was time (pre-vs postoperative). The primary outcome variables were the sinus volume, mucosal thickening, iatrogenic alterations in the sinus anatomy, and rhinosinusitis symptoms, evaluated using the Sino-Nasal Outcome 20-item Test (SNOT-20). Descriptive statistics were computed for each variable, and paired analyses were used to compare the pre- and postoperative values. RESULTS: The data from 64 subjects (mean age 27; 59.4% were female; median follow-up 32.4 months, range 13 to 66 months) were studied. Postoperatively, 1.6% of the sample (0% preoperatively) had moderate-to-severe and 15.6% (3.1% preoperatively) had mild-to-moderate sinusitis symptoms. The rest of the sample presented with mild to no symptoms. The increase in the SNOT scores after surgery was statistically significant (P = .016). Radiologic evidence of postoperative inflammatory processes affecting the paranasal sinuses was found in 27.3% of the sinuses (9.4% preoperatively). The postoperative Lund-Mackay scores were significantly greater (P = .0005). A 19% decrease was found in the mean postoperative sinus volume, with a 37% incidence of iatrogenic injury. CONCLUSIONS: The study results indicate that Le Fort I osteotomies can have an important impact on sinus health. The postoperative radiologic evidence of maxillary sinus inflammatory processes and the incidence of rhinosinusitis symptoms and iatrogenic damage in these patients have led us to conclude that CBCT scans and the SNOT-20 questionnaire should be used routinely during postoperative monitoring. Larger long-term studies are warranted to clarify the postoperative outcomes and complications.
File Format	HTM / HTML
ISSN	02782391
Issue Number	2
Volume Number	74
e-ISSN	15315053
Journal	Journal of Oral and Maxillofacial Surgery
Language	English
Publisher	Elsevier
Publisher Date	2016-02-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Medicine__semicolon__otorhinolaryngology__semicolon__surgery Maxillary Sinusitis Epidemiology Osteotomy, Le Fort Statistics & Numerical Data Adolescent Adult Cohort Studies Cone-beam Computed Tomography Female Follow-up Studies Foreign Bodies Humans Iatrogenic Disease Imaging, Three-dimensional Longitudinal Studies Male Malocclusion, Angle Class Ii Surgery Malocclusion, Angle Class Iii Maxillary Sinus Pathology Middle Aged Nasal Mucosa Nasal Septum Retrospective Studies Rhinitis Treatment Outcome Young Adult Comparative Study Journal Article
Content Type	Text
Resource Type	Article
Subject	Oral Surgery Otorhinolaryngology Surgery

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