Abstract
BackgroundLe Fort I osteotomy is one of the surgical procedures now routinely and safely performed. It is possible to move the maxilla in three dimensions, but it is necessary to separate the bones around the maxillary sinus. Therefore, with surgery, maxillary sinus mucosal thickening occurs. By knowing the changes in the sinus mucosa after surgery and the factors affecting it, it is possible to better predict the outcomes of surgery and contribute to safer surgery. In this study, thickening of maxillary sinus mucosa before and after surgery in Le Fort I osteotomy was evaluated using multidetector-row computed tomography (MDCT) images, and the changes in mucosal thickening and the related factors were examined.MethodsUsing MDCT images, the maxillary sinus mucosa of 125 patients who had undergone Le Fort I osteotomy was retrospectively evaluated before surgery, 1 month after surgery, and 1 year after surgery. On the MDCT images, the maxillary sinus was judged as mucosal thickening and classified into three grades according to the proportion occupying the maxillary sinus. In the evaluation of factors related to mucosal thickening, the following eight factors were examined: sex, age, diagnosis, operating time, amount of postoperative bleeding, with/without bone graft, with/without multisegmental osteotomy, and with/without macrolide therapy after surgery.ResultsThe mean age at the time of surgery was 25.6 ± 8 years. Of all 125 patients, 66 had bilateral thickening, 19 had unilateral thickening, and 40 had no thickening. Factors that were significantly related to mucosal thickening were the operative time for the maxilla, bone grafts, and macrolide therapy after surgery.ConclusionsOperative time for the maxilla, bone grafts, and macrolide therapy after surgery were found to be related to mucosal thickening. In addition, MDCT scanning 1 month after surgery was considered to be appropriate for evaluation of maxillary sinus mucosal thickening.
Highlights
Le Fort I osteotomy is one of the surgical procedures routinely and safely performed
In Le Fort I osteotomy, it is possible to move the maxilla in three dimensions, but it is necessary to separate the bones around the maxillary sinus
Factors related to postoperative maxillary sinus mucosal thickening In the evaluation of factors related to mucosal thickening, the following eight factors were examined: sex, age, diagnosis, operating time, amount of postoperative bleeding, with/without bone graft in Le Fort I osteotomy, with/without multisegmental osteotomy in Le Fort I osteotomy, and with/without macrolide therapy after surgery
Summary
Le Fort I osteotomy is one of the surgical procedures routinely and safely performed. It is possible to move the maxilla in three dimensions, but it is necessary to separate the bones around the maxillary sinus. In this study, thickening of maxillary sinus mucosa before and after surgery in Le Fort I osteotomy was evaluated using multidetector-row computed tomography (MDCT) images, and the changes in mucosal thickening and the related factors were examined. In orthognathic surgery for patients with jaw deformity, Le Fort I osteotomy in combination with a mandibular osteotomy is one of the surgical procedures that is routinely and safely performed at many facilities. In Le Fort I osteotomy, it is possible to move the maxilla in three dimensions, but it is necessary to separate the bones around the maxillary sinus. Iwamoto et al Maxillofacial Plastic and Reconstructive Surgery (2019) 41:12 images, and the changes in mucosal thickening and related factors were examined
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