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Nasal airway function after Le Fort I osteotomy with maxillary impaction: A prospective study using the Nasal Obstruction Symptom Evaluation scale

  • Kim, Hyo Seong (Department of Plastic and Reconstructive Surgery, Myongji Hospital) ;
  • Son, Ji Hwan (Department of Plastic and Reconstructive Surgery, Myongji Hospital) ;
  • Chung, Jee Hyeok (Division of Pediatric Plastic Surgery, Seoul National University Children's Hospital) ;
  • Kim, Kyung Sik (Department of Plastic and Reconstructive Surgery, Myongji Hospital) ;
  • Choi, Joon (Department of Plastic and Reconstructive Surgery, Myongji Hospital) ;
  • Yang, Jeong Yeol (Department of Plastic and Reconstructive Surgery, Myongji Hospital)
  • Received : 2020.07.10
  • Accepted : 2020.11.10
  • Published : 2021.01.15

Abstract

Background This study evaluated changes in nasal airway function following Le Fort I osteotomy with maxillary impaction according to the Nasal Obstruction Symptom Evaluation (NOSE) scale. Methods This cohort study included 13 patients who underwent Le Fort I osteotomy with maxillary impaction. Nasal airway function was evaluated based on the NOSE scale preoperatively and at 3 months postoperatively. The change in the NOSE score was calculated as the preoperative score minus the postoperative score. If the normality assumptions for changes in the NOSE score were not met, a nonparametric test (the Wilcoxon signed-rank test) was used. Differences in NOSE score changes according to patient characteristics and surgical factors were evaluated using the Kruskal-Wallis test and the Mann-Whitney test. Results Patients ranged in age from 18 to 29 years (mean ±standard deviation [SD], 23.00±3.87 years). Three were men and 10 were women. Eleven patients (84%) had an acquired dentofacial deformity with skeletal class III malocclusion. The preoperative NOSE scores ranged from 40 to 90 (mean±SD, 68.92±16.68), and the postoperative NOSE scores ranged from 25 to 80 (53.84±18.83). The cohort as a whole showed significant improvement in nasal airway function following maxillary impaction (P=0.028). Eleven patients (84%) had either improved (n=8) or unchanged (n=3) postoperative NOSE scores. However, nasal airway function deteriorated in two patients. Patient characteristics and surgical factors were not correlated with preoperative or postoperative NOSE scores. Conclusions Nasal airway function as evaluated using the NOSE scale improved after maxillary impaction.

Keywords

References

  1. Guenthner TA, Sather AH, Kern EB. The effect of Le Fort I maxillary impaction on nasal airway resistance. Am J Orthod 1984;85:308-15. https://doi.org/10.1016/0002-9416(84)90188-X
  2. Erbe M, Lehotay M, Gode U, et al. Nasal airway changes after Le Fort I: impaction and advancement: anatomical and functional findings. Int J Oral Maxillofac Surg 2001;30:123-9. https://doi.org/10.1054/ijom.2000.0001
  3. Turvey TA, Hall DJ, Warren DW. Alterations in nasal airway resistance following superior repositioning of the maxilla. Am J Orthod 1984;85:109-14. https://doi.org/10.1016/0002-9416(84)90002-2
  4. Turvey TA, Earren DW. Impact of maxillary osteotomies on nasal breathing: orthognatic surgery. Oral Maxillofac Surg Clin North Am 1990;2:831-41. https://doi.org/10.1016/S1042-3699(20)30466-0
  5. Bermuller C, Kirsche H, Rettinger G, et al. Diagnostic accuracy of peak nasal inspiratory flow and rhinomanometry in functional rhinosurgery. Laryngoscope 2008;118:605-10. https://doi.org/10.1097/MLG.0b013e318161e56b
  6. Kahveci OK, Miman MC, Yucel A, et al. The efficiency of Nose Obstruction Symptom Evaluation (NOSE) scale on patients with nasal septal deviation. Auris Nasus Larynx 2012;39:275-9. https://doi.org/10.1016/j.anl.2011.08.006
  7. Stewart MG, Witsell DL, Smith TL, et al. Development and validation of the Nasal Obstruction Symptom Evaluation (NOSE) scale. Otolaryngol Head Neck Surg 2004;130:157-63. https://doi.org/10.1016/j.otohns.2003.09.016
  8. Stewart MG, Smith TL, Weaver EM, et al. Outcomes after nasal septoplasty: results from the Nasal Obstruction Septoplasty Effectiveness (NOSE) study. Otolaryngol Head Neck Surg 2004;130:283-90. https://doi.org/10.1016/j.otohns.2003.12.004
  9. Haarmann S, Budihardja AS, Wolff KD, et al. Changes in acoustic airway profiles and nasal airway resistance after Le Fort I osteotomy and functional rhinosurgery: a prospective study. Int J Oral Maxillofac Surg 2009;38:321-5. https://doi.org/10.1016/j.ijom.2009.01.006
  10. Williams BJ, Isom A, Laureano Filho JR, et al. Nasal airway function after maxillary surgery: a prospective cohort study using the nasal obstruction symptom evaluation scale. J Oral Maxillofac Surg 2013;71:343-50. https://doi.org/10.1016/j.joms.2012.05.010
  11. Obwegeser HL. Surgical correction of small or retrodisplaced maxillae: the "dish-face" deformity. Plast Reconstr Surg 1969;43:351-65. https://doi.org/10.1097/00006534-196904000-00003
  12. Lang C, Grutzenmacher S, Mlynski B, et al. Investigating the nasal cycle using endoscopy, rhinoresistometry, and acoustic rhinometry. Laryngoscope 2003;113:284-9. https://doi.org/10.1097/00005537-200302000-00016
  13. Cole P. Acoustic rhinometry and rhinomanometry. Rhinol Suppl 2000;16:29-34.
  14. Betts NJ, Vig KW, Vig P, et al. Changes in the nasal and labial soft tissues after surgical repositioning of the maxilla. Int J Adult Orthodon Orthognath Surg 1993;8:7-23.
  15. Movahed R, Morales-Ryan C, Allen WR, et al. Outcome assessment of 603 cases of concomitant inferior turbinectomy and Le Fort I osteotomy. Proc (Bayl Univ Med Cent) 2013;26:376-81. https://doi.org/10.1080/08998280.2013.11929010
  16. Posnick JC, Fantuzzo JJ, Troost T. Simultaneous intranasal procedures to improve chronic obstructive nasal breathing in patients undergoing maxillary (Le Fort I) osteotomy. J Oral Maxillofac Surg 2007;65:2273-81. https://doi.org/10.1016/j.joms.2007.06.618
  17. Elad D, Liebenthal R, Wenig BL, et al. Analysis of air flow patterns in the human nose. Med Biol Eng Comput 1993; 31:585-92. https://doi.org/10.1007/BF02441806
  18. Garth RJ, Cox HJ, Thomas MR. Haemorrhage as a complication of inferior turbinectomy: a comparison of anterior and radical trimming. Clin Otolaryngol Allied Sci 1995;20: 236-8. https://doi.org/10.1111/j.1365-2273.1995.tb01856.x
  19. Young T, Finn L, Kim H. Nasal obstruction as a risk factor for sleep-disordered breathing. The University of Wisconsin Sleep and Respiratory Research Group. J Allergy Clin Immunol 1997;99:S757-62. https://doi.org/10.1016/S0091-6749(97)70124-6
  20. Young T, Finn L, Palta M. Chronic nasal congestion at night is a risk factor for snoring in a population-based cohort study. Arch Intern Med 2001;161:1514-9. https://doi.org/10.1001/archinte.161.12.1514
  21. Cooper BC. Nasorespiratory function and orofacial development. Otolaryngol Clin North Am 1989;22:413-41. https://doi.org/10.1016/S0030-6665(20)31448-1
  22. Linder-Aronson S. Adenoids: their effect on mode of breathing and nasal airflow and their relationship to characteristics of the facial skeleton and the denition: a biometric, rhinomanometric and cephalometro-radiographic study on children with and without adenoids. Acta Otolaryngol Suppl 1970;265:1-132.
  23. Yamada T, Tanne K, Miyamoto K, et al. Influences of nasal respiratory obstruction on craniofacial growth in young Macaca fuscata monkeys. Am J Orthod Dentofacial Orthop 1997;111:38-43. https://doi.org/10.1016/S0889-5406(97)70300-7
  24. Rubin RM. Mode of respiration and facial growth. Am J Orthod 1980;78:504-10. https://doi.org/10.1016/0002-9416(80)90301-2
  25. McNamara JA Jr. Naso-respiratory function and craniofacial growth (Monograph 9, Craniofacial Growth Series). Ann Arbor: University of Michigan Press; 1979.