Two Cases of Nasal Cavity Deformity after Le Fort I Osteotomy

Abstract

Jaw deformity causes bite disorder and facial deformity due to the abnormal size and morphology of the maxilla and/or mandible. The purpose of surgery for jaw deformity is to improve bite disorder and balance the maxilla and mandible. Such surgery is generally performed by an oral surgeon or plastic surgeon in Japan, while most otorhinolaryngologists are unfamiliar with jaw deformity surgery. The typical procedures used to correct jaw deformity are Le Fort I osteotomy for the maxilla and sagittal split mandibular osteotomy, intraoral vertical ramus osteotomy, or mentoplasty for the mandible. However, moving the maxilla upward may affect the morphology of the nasal cavity. Here, we report two cases of abnormal nasal cavity morphology after Le Fort I osteotomy. As both patients had anterior septal deviation and no change in facial appearance, we performed septoplasty via the hemitransfixion approach and bilateral submucosal turbinectomy. Nasal congestion improved postoperatively. Surgery that makes the maxilla move upward, such as Le Fort I osteotomy, carries a risk of abnormal nasal cavity morphology in which the nasal septum is separated from the anterior nasal spine during the operation. Thus, surgical techniques such as septoplasty via the hemitransfixion approach and open septorhinoplasty may be required. The appropriate procedure should be selected individually depending on the findings for each patient.