Influence of the Inferior Turbinate on the Accuracy of Superior Maxillary Repositioning in Le Fort I Osteotomy With/Without Adjunctive Technique.

Abstract

Previously, the authors reported that the amount of bony tissue inside the inferior nasal turbinate affects the precision of maxillary superior repositioning in conventional Le Fort I osteotomy (LFI) cases. Therefore, the authors conducted a retrospective study to examine whether adjunctive techniques such as horseshoe osteotomy or partial inferior turbinate resection could avoid interfering with the inferior nasal turbinate and nasal floor while improving the accuracy of maxillary superior repositioning in patients with well-developed bony tissue in the inferior nasal turbinate. Of the 163 patients with facial deformities who underwent conventional LFI (with maxillary elevation of 4.0-6.0 mm), most of whom also underwent bilateral sagittal split ramus osteotomy. The conventional LFI group included 54 cases in the large bone subgroup and 73 cases in the small bone subgroup, and LFI with adjunctive technique included 15 cases in the large bone subgroup and 21 cases in the small bone subgroup. The planned or actual amount of superior repositioning was compared three-dimensionally. The accuracy of the actual maxillary repositioning was significantly better in the small bone subgroup than in the large bone subgroup in conventional LFI group (P = 0.025). In addition, the presence of an adjunctive technique influences the accuracy of maxillary superior repositioning. For patients undergoing maxillary superior repositioning (>4.0 mm) with well-developed bony tissue of inferior nasal turbinate, an adjunctive technique (horseshoe osteotomy or partial inferior turbinectomy) should be considered. This prevents interference between the inferior nasal turbinate and the maxillary bone fragments, achieving greater accuracy in maxillary repositioning.