Effect of orthognathic surgery on middle ear condition

Abstract

ObjectivesThe aim of this study was to determine the effects of orthognathic surgery on middle ear condition assessed by tympanometry. Materials and methodsThe subjects were 239 patients in whom jaw deformities were surgically corrected. Bilateral sagittal split osteotomies were performed in 80 patients and a combination of Le Fort I osteotomy and bilateral sagittal split osteotomies was used in 159 patients. Tympanometry was performed before surgery and one day, three days, five days, seven days and nine days after surgery. Tympanometric peak pressure and static compliance were used to assess Eustachian tube function, and the tympanograms were divided into three basic types. ResultsTympanometric peak pressure significantly decreased one day after surgery and gradually recovered within nine days after surgery. Tympanometric peak pressure immediately after surgery in the two-jaw surgery group was significantly lower than those in the one-jaw surgery group. The percentage of normal tympanogram decreased immediately after surgery, especially in the two jaw surgery group, and gradually recovered by nine days after surgery. The percentages of normal tympanogram in the patients with ear symptoms were significantly lower than those in the patients without ear symptoms for the entire period. ConclusionOrthognathic surgery, especially maxillary osteotomy, can cause Eustachian tube dysfunction, though it is mild and transient and requires no intervention in most cases. However, 13% of patients had Eustachian tube dysfunction at the end of the study. These results suggest the importance of careful monitoring middle ear condition in patients undergoing orthognathic surgery.