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Effects of modified step Le Fort I advancement surgery on nostril area and inferior nasal structures volume in class III patients: a retrospective clinical study

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Abstract

Objective

The effect of the modified step Le Fort I osteotomy on the inferior nasal structures and the nostril area was evaluated.

Materials and methods

This study included 24 patients who had modified step Le Fort I osteotomy. Inferior nasal concha volume (INCV), meatus nasi inferior volume (MNIV), the sum of both structures volume (TV), and nostril area (NA) were evaluated in pre- (T0) and postoperative (T1) periods.

Results

For all patients, NA increased both on the right side (p = 0.011) and left side (p = 0.050) after surgery. The INCV and TV values were lower in T1 than those in T0; however, a statistically significant decrease of INCV and TV was found only in the right side of males (p = 0.039 and p = 0.050, respectively). No significant difference was found in MNIV between T0 and T1 measurements (p > 0.05).

Conclusion

Maxillary advancement with the modified step Le Fort I osteotomy technique increased the NA, which may have a positive effect on breathing function. On the other hand, although TV tended to decrease, MNIV did not change after surgery as the same decreasing tendency also existed in INCV.

Clinical relevance

Step Le Fort I advancement surgery technique usually affects nasal structures positively regarding the nasal airway.

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References

  1. Minervini G, Romano A, Petruzzi M, Maio C, Serpico R, Di Stasio D, Lucchese A (2018) Oral-facial-digital syndrome (OFD): 31-year follow-up management and monitoring. J Biol Regul Homeost Agents 32:127–130

    Google Scholar 

  2. Akbulut N, Kursun Cakmak ES, Bayrak S (2020) Assessment of maxillary sinus changes after Le Fort I osteotomy surgery. J Craniofac Surg 31:497–501. https://doi.org/10.1097/SCS.0000000000006659

    Article  Google Scholar 

  3. Altug-Atac AT, Bolatoglu H, Memikoglu UT (2008) Facial soft tissue profile following bimaxillary orthognathic surgery. Angle Orthod 78:50–57. https://doi.org/10.2319/122206-525.1

    Article  Google Scholar 

  4. Neslihan I, Akbulut S, Akbulut N (2021) Soft tissue response after maxillary step surgery with or without ANS reduction. Cumhur Dent J 24:121–128. https://doi.org/10.7126/cumudj.810461

    Article  Google Scholar 

  5. Catherine Z, Scolozzi P (2019) Modified Le Fort I step osteotomy for improvement of paranasal flatness in maxillary deficiency: technical note and series of 24 cases. J Stomatol Oral Maxillofac Surg 120:559–565. https://doi.org/10.1016/j.jormas.2019.07.003

    Article  Google Scholar 

  6. Bennett MA, Wolford LM (1985) The maxillary step osteotomy and Steinmann pin stabilization. J Oral Maxillofac Surg 43:307–311. https://doi.org/10.1016/0278-2391(85)90297-6

    Article  Google Scholar 

  7. Chew MT (2005) Soft and hard tissue changes after bimaxillary surgery in Chinese class III patients. Angle Orthod 75:959–963. https://doi.org/10.1043/0003-3219(2005)75[959:SAHTCA]2.0.CO;2

    Article  Google Scholar 

  8. Louis PJ, Austin RB, Waite PD, Mathews CS (2001) Soft tissue changes of the upper lip associated with maxillary advancement in obstructive sleep apnea patients. J Oral Maxillofac Surg 59:151–156. https://doi.org/10.1053/joms.2001.20485

    Article  Google Scholar 

  9. Soncul M, Bamber MA (2004) Evaluation of facial soft tissue changes with optical surface scan after surgical correction of Class III deformities. J Oral Maxillofac Surg 62:1331–1340. https://doi.org/10.1016/j.joms.2004.04.019

    Article  Google Scholar 

  10. Leong SC, Eccles R (2009) A systematic review of the nasal index and the significance of the shape and size of the nose in rhinology. Clin Otolaryngol 34:191–198. https://doi.org/10.1111/j.1749-4486.2009.01905.x

    Article  Google Scholar 

  11. Sforza C, Grandi G, De Menezes M, Tartaglia GM, Ferrario VF (2011) Age- and sex-related changes in the normal human external nose. Forensic Sci Int 204:205. https://doi.org/10.1016/j.forsciint.2010.07.027

    Article  Google Scholar 

  12. Allar ML, Movahed R, Wolford LM, Oliver DR, Harrison SD, Thiesen G, Kim KB (2019) Nasolabial changes following double jaw surgery. J Craniofac Surg 30:2560–2564. https://doi.org/10.1097/SCS.0000000000005876

    Article  Google Scholar 

  13. Altman JI, Oeltjen JC (2007) Nasal deformities associated with orthognathic surgery: analysis, prevention, and correction. J Craniofac Surg 18:734–739. https://doi.org/10.1097/SCS.0b013e3180684328

    Article  Google Scholar 

  14. Atakan A, Ozcirpici AA, Pamukcu H, Bayram B (2020) Does Le Fort I osteotomy have an influence on nasal cavity and septum deviation? Niger J Clin Pract 23:240–245. https://doi.org/10.4103/njcp.njcp_355_19

    Article  Google Scholar 

  15. Dantas WR, Silveira MM, Vasconcelos BC, Porto GG (2015) Evaluation of the nasal shape after orthognathic surgery. Braz J Otorhinolaryngol 81:19–23. https://doi.org/10.1016/j.bjorl.2014.08.005

    Article  Google Scholar 

  16. Erbe M, Lehotay M, Gode U, Wigand ME, Neukam FW (2001) Nasal airway changes after Le Fort I--impaction and advancement: anatomical and functional findings. Int J Oral Maxillofac Surg 30:123–129. https://doi.org/10.1054/ijom.2000.0001

    Article  Google Scholar 

  17. Jeong HI, Lee HS, Jung YS, Park HS, Jung HD (2017) Nasal soft tissue change following bimaxillary orthognathic surgery. J Craniofac Surg 28:605–608. https://doi.org/10.1097/SCS.0000000000003736

    Article  Google Scholar 

  18. Khamashta-Ledezma L, Naini FB, Manisali M (2017) Review of nasal changes with maxillary orthognathic surgery. J Istanb Univ Fac Dent 51:52–61. https://doi.org/10.17096/jiufd.09789

    Article  Google Scholar 

  19. Lee HJ, Park HS, Kyung HM, Kwon TG (2015) Soft tissue changes and skeletal stability after modified quadrangular Le Fort I osteotomy. Int J Oral Maxillofac Surg 44:356–361. https://doi.org/10.1016/j.ijom.2014.10.019

    Article  Google Scholar 

  20. Mirmohamadsadeghi H, Zanganeh R, Barati B, Tabrizi R (2020) Does maxillary superior repositioning affect nasal airway function? Br J Oral Maxillofac Surg 58:807–811. https://doi.org/10.1016/j.bjoms.2020.04.020

    Article  Google Scholar 

  21. Park SB, Yoon JK, Kim YI, Hwang DS, Cho BH, Son WS (2012) The evaluation of the nasal morphologic changes after bimaxillary surgery in skeletal class III maloccusion by using the superimposition of cone-beam computed tomography (CBCT) volumes. J Craniomaxillofac Surg 40:87–92. https://doi.org/10.1016/j.jcms.2011.05.008

    Article  Google Scholar 

  22. Pourdanesh F, Sharifi R, Mohebbi A, Jamilian A (2012) Effects of maxillary advancement and impaction on nasal airway function. Int J Oral Maxillofac Surg 41:1350–1352. https://doi.org/10.1016/j.ijom.2012.03.024

    Article  Google Scholar 

  23. Schendel SA, Carlotti AE Jr (1991) Nasal considerations in orthognathic surgery. Am J Orthod Dentofacial Orthop 100:197–208. https://doi.org/10.1016/0889-5406(91)70056-3

    Article  Google Scholar 

  24. Turvey TA, Hall DJ, Warren DW (1984) Alterations in nasal airway resistance following superior repositioning of the maxilla. Am J Orthod Dentofacial Orthop 85:109–114. https://doi.org/10.1016/0002-9416(84)90002-2

    Article  Google Scholar 

  25. Worasakwutiphong S, Chuang YF, Chang HW, Lin HH, Lin PJ, Lo LJ (2015) Nasal changes after orthognathic surgery for patients with prognathism and Class III malocclusion: analysis using three-dimensional photogrammetry. JFMA 114:112–123. https://doi.org/10.1016/j.jfma.2014.10.003

    Article  Google Scholar 

  26. Yamashsita Y, Iwai T, Honda K, Fujita K, Imai H, Takasu H, Omura S, Hirota M, Mitsudo K (2020) Effectiveness of subspinal Le Fort I osteotomy in preventing postoperative nasal deformation. J Plast Reconstr Aesthet Surg 73:1326–1330. https://doi.org/10.1016/j.bjps.2020.02.014

    Article  Google Scholar 

  27. Steegman R, Hogeveen F, Schoeman A, Ren Y (2022) Cone beam computed tomography volumetric airway changes after orthognathic surgery: a systematic review. Int J Oral Maxillofac Surg. https://doi.org/10.1016/j.ijom.2022.05.013

  28. Nigro CE, Nigro JF, Mion O, Mello JF Jr (2009) Nasal valve: anatomy and physiology. Braz J Otorhinolaryngol 75:305–310. https://doi.org/10.1016/s1808-8694(15)30795-3

    Article  Google Scholar 

  29. Bohluli B, Varedi P, Kahali R, Bagheri SC (2015) External Nasal Valve Efficacy Index: a simple test to evaluate the external nasal valve. Int J Oral Maxillofac Surg 44:1240–1245. https://doi.org/10.1016/j.ijom.2015.05.007

    Article  Google Scholar 

  30. El-Anwar MW, Hamed AA, Abdulmonaem G, Elnashar I, Elfiki IM (2017) Computed tomography measurement of inferior turbinate in asymptomatic adult. Int Arch Otorhinolaryngol 21:366–370. https://doi.org/10.1055/s-0037-1598649

    Article  Google Scholar 

  31. Fastuca R, Lorusso P, Lagravere MO, Michelotti A, Portelli M, Zecca PA, D’Antò V, Militi A, Nucera R, Caprioglio A (2017) Digital evaluation of nasal changes induced by rapid maxillary expansion with different anchorage and appliance design. BMC Oral Health 17:113. https://doi.org/10.1186/s12903-017-0404-3

    Article  Google Scholar 

  32. Neeraj RSG, Dixit A, Agarwal P, Chowdhry R, Chug A (2021) Relapse and temporomandibular joint dysfunction (TMD) as postoperative complication in skeletal class III patients undergoing bimaxillary orthognathic surgery: a systematic review. J Oral Biol Craniofac Res 11:467–475. https://doi.org/10.1016/j.jobcr.2021.06.003

    Article  Google Scholar 

  33. Minervini G, Russo D, Herford AS, Gorassini F, Meto A, D’Amico C, Cervino G, Cicciu M, Fiorillo L (2022) Teledentistry in the management of patients with dental and temporomandibular disorders. BioMed Res Int 2022:7091153. https://doi.org/10.1155/2022/7091153

    Article  Google Scholar 

  34. Markic G, Muller L, Patcas R, Roos M, Lochbuhler N, Peltomaki T, Karlo CA, Ullrich O, Kellenberger CJ (2015) Assessing the length of the mandibular ramus and the condylar process: a comparison of OPG, CBCT, CT, MRI, and lateral cephalometric measurements. Eur J Orthod 37:13–21. https://doi.org/10.1093/ejo/cju008

    Article  Google Scholar 

  35. Guyader E, Savean J, Clodic C, Letellier P, Meriot P, Marianowski R (2018) Three-dimensional reconstruction of the temporal bone: comparison of in situ, CT, and CBCT measurements. Eur Ann Otorhinolaryngol Head Neck Dis 135:393–398. https://doi.org/10.1016/j.anorl.2018.08.013

    Article  Google Scholar 

  36. Rosen HM (1988) Lip-nasal aesthetics following Le Fort I osteotomy. Plast Reconstr Surg 81:171–182. https://doi.org/10.1097/00006534-198802000-00005

    Article  Google Scholar 

  37. Almuzian M, Almukhtar A, Ju X, Al-Hiyali A, Benington P, Ayoub A (2016) Effects of Le Fort I osteotomy on the nasopharyngeal airway-6-month follow-up. J Oral Maxillofac Surg 74:380–391. https://doi.org/10.1016/j.joms.2015.06.172

    Article  Google Scholar 

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Authors and Affiliations

  1. Oral and Maxillofacial Surgery Department, Dentistry Faculty, Ondokuz Mayıs University, Samsun, Turkey

    Nihat Akbulut

  2. Orthodontics Department, Dentistry Faculty, Ondokuz Mayıs University, Samsun, Turkey

    Sibel Akbulut

  3. Oral and Maxillofacial Radiology Department, Dentistry Faculty, Bolu Abant Izzet Baysal University, Golkoy, Bolu, Turkey

    Seval Bayrak

  4. Oral and Maxillofacial Surgery Department, Dentistry Faculty, Tokat Gaziosmanpaşa University, Tokat, Turkey

    Esengül Şen, Gizemnur Kaymaz & Sefa Çolak

  5. Oral and Maxillofacial Surgery Department, Dentistry Faculty, Necmettin Erbakan University, Konya, Turkey

    Ahmet Altan

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  1. Nihat Akbulut
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Correspondence to Seval Bayrak.

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The Institutional Review Board and Clinical Ethics committee of Tokat Gaziosmanpasa University Medicine Faculty approved this retrospective clinical study (Registration number: 20-KAEK-269).

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Akbulut, N., Akbulut, S., Bayrak, S. et al. Effects of modified step Le Fort I advancement surgery on nostril area and inferior nasal structures volume in class III patients: a retrospective clinical study. Clin Oral Invest 27, 807–815 (2023). https://doi.org/10.1007/s00784-023-04860-3

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