A modified Le Fort I Osteotomy Designed to Minimize Nasal Changes Associated With Maxillary Advancement Performed for Maxillary Hypoplasia.

Background/objective: This study aimed to evaluate nasal changes in maxillary advancement in patients undergoing to prevent nasal base widening after modified Le Fort I osteotomy.

Methods: A retrospective cohort study of 26 subjects undergoing modified Le Fort I osteotomy for Class III malocclusion was implemented. Patients undergoing Lefort I advancement and bilateral sagittal split osteotomy receive a Cinch suture before wound closure. Facial soft tissue landmarks of the nose including nasal height, nasal length, nasal tip projection, alar width, alar base width, Philtrum length, nasolabial angle, nasofrontal angle, and columella inclination before and at 12 months after surgery were obtained by a 3D stereophotogrammetry.

Results: No significant changes in nasal height, length, columellar length, or vertical height after maxillary advancement with modified Le Fort I osteotomy. Nasal tip projection increased but not significantly. Modified Le Fort I osteotomy did not change alar basal width after maxillary advancement. However, alar width widening was significantly different (P<0.001). The majority of nasal angles showed preoperative and postoperative nasolabial angle differences (Preop: 98.38 postop: 99.96) without statistical significance.

Conclusion: This study suggests that the modified Le Fort I osteotomy is effective in preventing significant nasal changes in case of maxillary advancement with promising results in addressing mid-face retrusion.