Abstract:
Superior repositioning of the maxilla during Le Fort I osteotomy (LFI) may narrow the inferior nasal passage. This retrospective study was performed to investigate morphological changes in the inferior nasal passage following LFI with/without additional procedures performed for nasal ventilation (horseshoe osteotomy or inferior turbinate partial resection). Three groups of patients were compared: those undergoing conventional LFI (Conv, 63 patients), LFI with horseshoe osteotomy (Hs, eight patients), and LFI with inferior turbinate partial resection (Turb, 21 patients). Coronal computed tomography images were used to evaluate the degree of stenosis of the inferior nasal passage. The soft tissue and bony tissue volumes in the inferior turbinate were also calculated three-dimensionally. The rate of obstruction of the inferior nasal passage postoperative was 65.9%, 50%, and 11.9% in the Conv, Hs, and Turb groups, respectively (Fisher\'s exact test, P < 0.001). Patients in the Turb group had significantly less nasal obstruction regardless of the pitch direction of the maxillary movement or volume of the bone in the inferior turbinate (all P < 0.001). In conclusion, for patients with high superior repositioning and well-developed bony tissue in the inferior turbinate, additional procedures are recommended to maintain the ventilation of the nasal passage postoperatively.
摘要:
在LeFortI截骨术(LFI)期间上颌骨的高级重新定位可能会缩小下鼻通道。进行这项回顾性研究是为了研究LFI后下鼻道的形态变化,有/没有进行额外的鼻通气手术(马蹄截骨或下鼻甲部分切除术)。比较三组患者:接受常规LFI的患者(Conv,63名患者),LFI与马蹄形截骨术(Hs,八名患者),和下鼻甲部分切除术的LFI(Turb,21名患者)。冠状计算机断层扫描图像用于评估下鼻道的狭窄程度。下鼻甲的软组织和骨组织体积也进行了三维计算。术后下鼻道阻塞率为65.9%,50%,和11.9%在Conv中,Hs,和Turb组,分别(费舍尔精确检验,P<0.001)。无论上颌运动的螺距方向或下鼻甲的骨体积如何,Turb组患者的鼻塞明显减少(均P<0.001)。总之,对于高度上重新定位和下鼻甲骨组织发育良好的患者,建议在术后进行额外的手术以维持鼻腔通气.