title: Nasal Airway Evaluation After Le Fort I Osteotomy Combined With Septoplasty in Patients With Cleft Lip and Palate.
abstract: Septal deviation constitutes an important component of both esthetic deformity and airway compromise in patients with cleft lip and palate (CLP). The posterior parts of the nasal septum presented greater deviation than the anterior parts in patients with complete unilateral CLP. Le Fort I down-fracture provides better access to the nasal septum than intranasal incision during rhinoplasty, especially to the posterior part. This study objectively and subjectively evaluated the nasal function after Le Fort I osteotomy combined with septoplasty in patients with complete unilateral CLP. Twenty-three patients with complete unilateral CLP presenting with nasal obstruction and septum deviation were included (12-combined surgery group; 11-control group). Types of septum deviation in the patients were analyzed. Presurgical and 6-month-postsurgical acoustic rhinometry (AR) was performed for objective assessment; and the nasal obstruction symptom evaluation (NOSE) scale was used for subjective assessment. The authors used SPSS to compare the baseline and follow-up results. Acoustic rhinometry assessment showed improvements in the nasal minimal cross-sectional area (MCA), nasal resistance, and nasal volumes in 12 patients who received combined surgery. For the 2 groups, significant improvements in nasal breathing were documented (by NOSE scores) at 6 months after surgery. Simultaneous management of the maxillary dysplasia (Le Fort I osteotomy) and intranasal pathology (septoplasty) were effective for relief of nasal airway obstruction in patients with complete unilateral CLP. The combination of objective (AR) and subjective (NOSE scale) assessments allowed better evaluation of the nasal function.
authors.affiliation: *Department of Otorhinolaryngology, The Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine †Department of Plastic Surgery, The Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine ‡Department of Oral and Maxillofacial Surgery, The Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Zhongying
authors.initials: Z
authors.lastname: Wang
authors.forename: Peihua
authors.initials: P
authors.lastname: Wang
authors.forename: Yixin
authors.initials: Y
authors.lastname: Zhang
authors.forename: Guofang
authors.initials: G
authors.lastname: Shen
mesh_terms: D000293:Adolescent; D000328:Adult; D002971:Cleft Lip / Q000150:complications / Q000601:surgery*; D002972:Cleft Palate / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D015508:Nasal Obstruction / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D009300:Nasal Septum / Q000601:surgery*; D019340:Osteotomy, Le Fort / Q000379:methods*; D023842:Rhinometry, Acoustic; D012225:Rhinoplasty / Q000379:methods*; D055815:Young Adult