Evaluation of Related Factors of Maxillary Sinusitis After Le Fort I Osteotomy Based on Computed Tomography: A Retrospective Case-Control Study

Abstract

: Maxillary sinusitis is 1 of the postoperative complications of the Le Fort I osteotomy, this study investigated the related factors of maxillary sinusitis after Le Fort I osteotomy. A total of 23 cases, 92 controls, and 11 related factors were included in this case-control study with a 1:4 case-control ratio. The risk factors for maxillary sinusitis after Le Fort I were examined by least absolute shrinkage and selection operator multivariate conditional logistic regression and least absolute shrinkage and selection operator multivariate linear regression. The patency of maxillary sinus ostium at 6 months after surgery was significantly associated with maxillary sinusitis after Le Fort I osteotomy. Compared with the obstructed maxillary sinus ostium, the percentage of the volume of the healthy air cavity in the complete sinus cavity increased 70.7% when the maxillary sinus ostium was unobstructed, and 95% confidence interval was 0.610 to 0.805. Similarly, when the maxillary sinus ostium was wide, the percentage increased 6.0% compared with the narrow 1, and 95% confidence interval was 0.013 to 0.107. This study indicated that the patency of maxillary sinus ostium has an important impact on maxillary sinusitis after Le Fort I osteotomy. Close attention should be paid to maintain the maxillary sinus ostium and the drainage of maxillary sinuses unobstructed in a clinical setting.

Chronic Rhinosinusitis After Maxillary Advancement Orthognathic Surgery

“…In this particular study, data was collected between 8 weeks and 23 months after their maxillary advancement surgery. 17 In our cohort, the incidence of newly diagnosed CRS after MMA surgery was 7.2%. Importantly, our study included patients with a relatively low prevalence of comorbidities typically associated with type 2 inflammatory CRS, including asthma, allergic rhinitis, and aspirin sensitivity, suggesting that the etiologies of sinonasal inflammation in this particular cohort is primarily due to alterations in maxillary sinus bony and mucosal integrity, which may negatively affect mucociliary clearance in this region.…”

“…MMA appears to promote ongoing inflammation and/or infection by disrupting mucosal integrity, creating competing inferior meatal windows, and narrowing sinus outflow tracts (Figure 2). 17,19 Our findings suggest that CRS after MMA primarily manifests as inflammatory changes in the sinuses associated with the ostiomeatal complex. Indeed, evidence of sinus mucosal thickening was most commonly observed radiographically in the maxillary and anterior ethmoid sinuses, suggesting that anatomic alteration of the maxillary sinus may affect mucociliary clearance in this region.…”

Incidence of Sinusitis Postoperatively in Orthognathic Surgery: A Systematic Review and Meta-Analysis

“…22 studies reported on gender, and there were 2054 female participants. Wang et al 4 and de Mol van Otterloo et al 24 did not report on age and gender. All participants underwent orthognathic surgery and were followed up postsurgery for complications.…”

“…Additionally, these disruptions may lead to blood and other fluids to accumulate within the sinus. These factors can result in sinus inflammation or sinusitis 4 . Despite the potential risk of sinusitis as a complication in Le Fort I osteotomy and other forms of orthognathic surgery, no systematic review examines the incidence of sinusitis in any form of orthognathic surgery.…”

“…These factors can result in sinus inflammation or sinusitis. 4 Despite the potential risk of sinusitis as a complication in Le Fort I osteotomy and other forms of orthognathic surgery, no systematic review examines the incidence of sinusitis in any form of orthognathic surgery. The purpose of this systematic review is to explore the incidence of sinusitis postorthognathic surgery.…”