Impact of Le-Fort I osteotomy on anatomical and functional aspects of the nasal airway and on quality of life
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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.
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.
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).
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.
KeywordsLe Fort-I-osteotomy Nasal airway space Orthognathic surgery Rhinomanometry Quality of life
All authors made substantial contributions to the study and have approved the final article. MP: designed and coordinated the study, participated in data acquisition and analysis, interpreted the data and drafted the manuscript. RK: participated in data acquisition and analysis, coordinated the study and critically revised the manuscript for important intellectual content. IB: participated in data interpretation and revision of the manuscript. DLS: participated in data interpretation and revision of the manuscript. OR: participated in data interpretation and revision of the manuscript. KZ: designed and coordinated the study, participated in data acquisition and analysis, critically revised the manuscript for important intellectual content. CF: designed and coordinated the study, participated in data acquisition and analysis, interpreted the data, critically revised the manuscript for important intellectual content.
No external/additional funding was received for this study.
Compliance with ethical standards
Conflict of interest
All authors declare that they have no conflict of interest.
Informed consent was obtained from all individual participants included in the study.
The Ethics Committee of the Medical Faculty at the University of Heidelberg granted permission to conduct the study (project no S-533/2017).
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