The effect of maxillary multidirectional movement on nasal respiration.
OBJECTIVE
Deformities of the maxilla may exist on all planes, and we treat these problems by mobilizing and repositioning the maxilla on all planes. Some authors have examined the effects of maxillary movement on the nasal airway. In clinical, practice, active anterior rhinomanometry is the most reliable and frequently used method to assess nasal respiratory function. The purpose of this study was to evaluate changes in nasal airflow and nasal airway resistance after maxillary movement performed by active anterior rhinomanometry.


METHODS
We studied 25 patients (18 female patients and 7 male patients; aged 16-30 years) in this clinical trial. Three days before surgery and 6 months after surgery, after a rest period of 30 minutes, active anterior rhinomanometry with a tube was performed at a fixed transnasal pressure of 150 Pa. The surgical treatment plan included bimaxillary surgery consisting of a 1-piece Le Fort I osteotomy combined with a bilateral sagittal split osteotomy. Mean and median total nasal airflow and nasal resistance rate were calculated before surgery and after surgery and compared by use of SPSS software (version 11.5; SPSS, Chicago, IL) and paired t test.


RESULTS
An increase in nasal airflow (P = .009) and a decrease in nasal resistance (P = .022) were observed in the maxillary impaction and advancement group. In the maxillary impaction and setback group, there was a significant difference in nasal resistance changes (P = .027); however, postsurgical nasal airflow compared with presurgical values showed no statistically significant difference (P = .244).


CONCLUSIONS
Impaction and advancement of the maxilla can improve nasal respiratory function, but maxillary impaction and setback reduce nasal respiratory function. Hence candidates for maxillary impaction and setback must be informed about decreased nasal respiratory function.
Ghoreishian
Mehdi
M
Department of Oral and Maxillofacial Surgery, Torabinejad Dental Research Center, and Isfahan University of Medical Sciences, Isfahan, Iran.
Gheisari
Rasoul
R
D000293:Adolescent; D000328:Adult; D000403:Airway Resistance / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery; D008437:Maxilla / Q000002:abnormalities / Q000601:surgery*; D009300:Nasal Septum / Q000601:surgery; D009666:Nose / Q000503:physiopathology*; D010027:Osteotomy / Q000379:methods; D019340:Osteotomy, Le Fort / Q000379:methods; D012119:Respiration; D015656:Respiratory Mechanics / Q000502:physiology; D025363:Rhinomanometry; D055815:Young Adult