Modified Le Fort I step osteotomy for improvement of paranasal flatness in maxillary deficiency: Technical note and series of 24 cases

Abstract

IntroductionTo describe a modified Le Fort I step osteotomy for the improvement of paranasal flatness in maxillary deficiency and to evaluate postoperative complications as well as post-treatment relapse. Patients and MethodsIn this retrospective case series study, clinical data of all patients with maxillary deficiency associated with a Class III malocclusion who underwent a modified Le Fort I step osteotomy were reviewed. The primary and secondary outcome variables were, respectively, the improvement of paranasal flatness as evaluated by the clinical analysis of the cheekbone-nasal base-lip contour (CP-Nb-LC), and postoperative complications as well as post-treatment relapse. Other variables included age, gender, and additional surgical procedures. Descriptive statistics were performed. ResultsThe sample was composed of 24 patients. Paranasal flatness was corrected with the reestablishment of an harmonious convex cheekbone-nasal base-lip contour in all patients, who were satisfied with the esthetic result. Two patients (8%) had discomfort associated with the paranasal plates. One of these also had a unilateral nasolacrimal duct dysfunction with occasional bothersome epiphora that resolved after plate removal. Two patients (8%) had maxillary sinusitis that resolved rapidly following medical treatment. One patient (4%) had persistent minor infraorbital nerve hypoesthesia. No occlusal relapse or pseudarthrosis occurred. ConclusionThe modified Le Fort I step osteotomy approach is a valuable method for the improvement of paranasal flatness in maxillary deficiency.