Assessment of Nasal Septum Change after Le Fort I Osteotomy Using Cone Beam Computed Tomography.

Abstract

Le Fort I osteotomy (LF-IO) is widely used for the correction of dentofacial deformities, which may cause changes in the postoperative nasal septum (NS). The objective of this study was to evaluate the effects of LF-IO on the NS deviation and to determine whether the NS was affected by differences in the direction of maxilla movement. A retrospective study including 57 patients who underwent LF-IO and received cone beam computed tomography (CBCT) preoperatively and 6-12months postoperative evaluation was performed. The NS angle of each patient was measured both pre- and postoperatively in the two coronal sections (nasion and ostium levels). The patients were divided into five paired groups and calculated. Group 1 to 4 were divided depending on the differences in the direction of maxilla movement (Group 1. Impaction ≥ 5mm vs. Impaction < 5mm; Group 2. Anterior movement vs. Non-anterior movement; Group 3. Impaction symmetry vs. Impaction asymmetry; and Group 4. Impaction vs. Inferior repositioning). Group 5 was divided as One-piece osteotomy vs. Multi-segmental osteotomy. The mean NS angles at both nasion and ostium levels of all patients were significant increased after LF-IO. However, there were no statistical significant differences of the five paired groups. LF-IO osteotomy influenced increasing of the NS deviation at both the nasion and ostium levels. However, differences in the direction of the maxilla movement and maxilla segmentation showed no statistically significant changes.