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ITALIAN JOURNAL OF MAXILLOFACIAL SURGERY
Rivista di Chirurgia Maxillo-Facciale
Official Journal of the Italian Society of Maxillofacial Surgery
Italian Journal of Maxillofacial Surgery 2009 August;20(2):103-10
Evaluation of the nasal airways after maxillary advancement and alar/septal suture
Ramieri G. A. 1, Roccia F. 1, Nasi A. 1, Pecorari G. C. 2, Verzè L. 3
1 Department of Maxillofacial Surgery, University of Turin, Turin, Italy
2 ENT Department, University of Turin, Turin, Italy
3 Department of Anatomy, Pharmacology and Forensic Medicine, University of Turin, Turin, Italy
Aim. Twenty patients were prospectively studied to assess functional and aesthetic changes of the nose after one–piece “Le Fort I” repositioning and alar/septal suturing.
Methods. Forward and upward repositioning of the maxilla was carried out using a standard surgical procedure, while low tension nasal septum fixation, nasal osteoplasty, alar base cinch suture and modified V-Y mucosal closure were performed. Presurgical and one-year postsurgical nasal optic fibres inspection and active mask rhinomanometry were obtained. Subjective nasal patency was evaluated with a questionnaire. At the same times, facial morphological data were acquired with a 3D optical laser scanner.
Results. Mean maxillary movements observed were advancement of 4 mm, anterior impaction of 3 mm and posterior impaction of 2 mm. Subjective assessment of nasal breathing and rhinoscopy revealed an evident improvement. Nasal resistance measured by rhinomanometry dropped significantly from T0 to T1.
Conclusion. It resulted that this surgical protocol allowed to control the inter-alar width and the nasal tip position with a rather pleasant and predictable outcome, while the surgical repositioning of the septum and contouring of the piriform rim achieved to significantly improve the nasal air flow. Moreover, a considerable subjective benefit was reported and a significant reduction of inferior turbinate hypertrophy was observed in most patients.