Assessment of internal nasal valve change after Le Fort I osteotomy using CBCT
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Abstract
Objective:The internal nasal valve (INV) is the narrowest portion of the nasal cavity and is affected by Le Fort I osteotomy (LF-IO). The objective of this study was to investigate the changes in the INV after LF-IO.
Materials and Methods: The retrospective cone beam computed tomography (CBCT) data of 57 patients who underwent LF-IO were evaluated before and 6−12 months postoperatively. The INV measurement (angle and cross-sectional area) was done at the reformatted coronal CBCT image perpendicular to the estimated nasal airflow axis. The patients were divided into 4 paired groups depending on the differences in the direction of the maxilla movement and investigated. (Group 1. Impaction vs. Inferior repositioning; Group 2. Impaction >5 mm vs. Impaction <5 mm; Group 3. Anterior movement vs. Non-anterior movement; Group 4. Impaction symmetry vs. Impaction asymmetry). Statistical significance was determined at p<0.05.
Results: Preoperatively, the mean INV angle and area of the patients was 18.92 + 5.12o and 76.63 + 16.99 mm2, respectively. After LF-IO, the mean INV angle of all patients was significantly increased by 2.31 + 3.87o (p<0.001), while the mean INV area was decreased by 0.34 + 16.24 o, which was not significant (p=0.826). However, when the results of the four paired groups were evaluated, there were no significant differences in the INV angle and INV area. The correlation between changes in INV angle and changes in INV area was weak (p=0.003, r=.279).
Conclusions: LF-IO osteotomy increased the INV angle, however, the differences in the direction of the maxilla movement were not significant. Impaction and advancement movement of the maxilla might increase the INV angle more than the inferior and setback movement. The INV area was not significantly different after surgery. A weak positive correlation between changes in INV angle and changes in INV area was found.
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