Simultaneous functional endoscopic sinus surgery and esthetic rhinoplasty in orthognathic patients.
OBJECTIVE
Patients treated for dentofacial deformities may be predisposed to aggravated sinonasal disease postoperatively, particularly if concurrent rhinoplasty is performed. The authors present their experience with simultaneous rhinoplasty, maxillary/mandibular osteotomies, and functional endoscopic sinus surgery (FESS).


METHODS
Thirteen patients were treated with simultaneous rhinoplasty, maxillary/mandibular osteotomies, and FESS from January 2002 to December 2005. An operative algorithm for patients with dentofacial deformities requiring rhinoplasty was developed. The surgical procedure was performed under general anesthesia with nasotracheal intubation and maxillary/mandibular osteotomies first. Nasotracheal intubation was then converted to orotracheal intubation and FESS was performed. The third step was correction of the esthetic deformities of the nose through an open approach.


RESULTS
In all cases, it was possible to successfully complete the combined operation. Median operation time was: 2 hours and 18 minutes for orthognathic bimaxillary surgery, 54 minutes for rhinoplastic surgery; and 23 minutes for FESS. All the patients had good esthetic and functional results and were free from symptoms consistent with previous rhinosinusitis.


CONCLUSIONS
The combination of orthognathic surgery, rhinoplasty, and FESS in selected cases is safe and effective.
Department of Maxillofacial Surgery, University of Udine, Udine, Italy. costa.fabio@aoud.sanita.fvg.it
Fabio
F
Costa
Massimo
M
Robiony
Iolanda
I
Salvo
Corrado
C
Toro
Salvatore
S
Sembronio
Massimo
M
Politi
D000328:Adult; D002508:Cephalometry; D004724:Endoscopy; D005260:Female; D006801:Humans; D019248:Jaw Fixation Techniques; D008297:Male; D008312:Malocclusion, Angle Class II / Q000601:surgery; D008313:Malocclusion, Angle Class III / Q000601:surgery; D008334:Mandible / Q000601:surgery; D008437:Maxilla / Q000601:surgery; D008443:Maxillary Sinus / Q000601:surgery*; D015523:Maxillary Sinusitis / Q000601:surgery; D015508:Nasal Obstruction / Q000601:surgery; D019647:Oral Surgical Procedures / Q000379:methods*; D012225:Rhinoplasty / Q000379:methods*