Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hacettepe, Ankara, Turkey.
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hacettepe, Ankara, Turkey.
Int J Oral Maxillofac Surg. 2022 Jun;51(6):806-812. doi: 10.1016/j.ijom.2021.10.006. Epub 2021 Nov 2.
This study was designed to evaluate the effects of different maxillary movements performed in Le Fort I surgery on the anatomy of the nasal cavity and maxillary sinus, occurrence of rhinosinusitis, and nasal airflow. Patients were divided into three groups: group I underwent pure advancement, group II underwent advancement with yaw rotation, and group III underwent advancement with impaction movements. All evaluations were performed using pre- and postoperative computed tomography images and surveys. Twenty-eight patients were enrolled. The mean pre- and postoperative nasal air volumes in group I were 22.74 ± 6.32 cm and 25.17 ± 6.19 cm, respectively, showing a significant increase (P = 0.041). The mean pre- and postoperative maxillary sinus air volumes were 33.94 ± 13.72 cm and 26.28 ± 14.12 cm in group II and 35.29 ± 9.58 cm and 28.65 ± 8.42 cm in group III, respectively, showing significant reductions (P = 0.028 and P = 0.007, respectively). For all movements, the occurrence of septum deviation and nasal airflow impairment was not statistically significant. Pure maxillary advancement movement enhanced nasal cavity air volume. The yaw rotation movement significantly increased quantitative clinical rhinosinusitis symptoms. The risk of airflow impairment following Le Fort I surgery is low.
本研究旨在评估 Le Fort I 手术中不同上颌骨移动方式对鼻腔和上颌窦解剖结构、鼻窦炎发生和鼻气流的影响。患者分为三组：I 组行单纯前徙，II 组行旋转前徙，III 组行前徙伴挤压。所有评估均采用术前和术后 CT 图像和问卷调查进行。共纳入 28 例患者。I 组术前和术后的平均鼻腔容积分别为 22.74±6.32cm 和 25.17±6.19cm，有显著增加（P=0.041）。II 组和 III 组术前和术后上颌窦容积分别为 33.94±13.72cm 和 26.28±14.12cm，35.29±9.58cm 和 28.65±8.42cm，均有显著减少（P=0.028 和 P=0.007）。对于所有的运动方式，鼻中隔偏曲和鼻气流障碍的发生率均无统计学意义。单纯上颌骨前徙运动增加了鼻腔容积。旋转前徙运动显著增加了定量临床鼻窦炎症状。Le Fort I 手术后气流障碍的风险较低。
