Determination of safety margin of nasal septum osteotomy for sphenoid sinus in cleft lip and palate patients.

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  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 101088684 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6831 (Electronic) Linking ISSN: 14726831 NLM ISO Abbreviation: BMC Oral Health Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2001-
    • Subject Terms:
      Sphenoid Sinus*/surgery ; Sphenoid Sinus*/diagnostic imaging ; Cleft Lip*/surgery ; Cleft Lip*/diagnostic imaging ; Cleft Palate*/surgery ; Cleft Palate*/diagnostic imaging ; Nasal Septum*/surgery ; Nasal Septum*/diagnostic imaging ; Cone-Beam Computed Tomography* ; Osteotomy, Le Fort*/methods; Humans ; Male ; Female ; Young Adult ; Adult ; Adolescent ; Case-Control Studies ; Osteotomy/methods ; Osteotomy/adverse effects
    • Abstract:
      Background: Nasal septum osteotomy is used for separating the nasal septum and maxilla during a Le Fort I osteotomy. If this osteotomy is applied too high or is tilted into the nasal cavity, the sphenoid sinus and various adjacent vital structures may be damaged, and serious bleeding, neurological complications, blindness or even death may occur. The aim of this study is to determine the safety margin of the nasal septum osteotomy for sphenoid sinus during the Le Fort I surgery in cleft lip and palate (CLP) patients.
      Methods: Twenty cleft lip and palate (the CLP group) and 20 healthy individuals (the control group) were included in this study. Three values (two lines and an angle) were measured by cone beam computed tomography (CBCT). The first line is the line passing through the junction of the spina nasalis anterior point and the lower point of the perpendicular lamina of the palatine bone. The undersired line is the line passing through the junction of the spina nasalis anterior point and the lower anterior border of the base of the sphenoid sinus. The osteotomy angle is the angle between these two lines.
      Results: In the control group; a surgical line of 44.11-61.14 mm (mean 51.91 ± 4.32), an undesired line of 52.48-69.58 mm (mean 59.14 ± 5.08) and an angle of 18.22-27.270 (mean 22.66 ± 2.55) were found, while in the CLP group, a surgical line of 34.53-51.16 mm (mean 43.38 ± 4.79), an undesired line of 46.86-61.35 mm (mean 55.02 ± 3.24) and an angle of 17.60-28.810 (mean 22.60 ± 2.81) were found.
      Conclusions: Although the angle to the sphenoid sinus was not significantly affected by CLP, careful planning and consideration of these anatomical differences are crucial to prevent complications and ensure the safety of Le Fort I surgery in CLP patients. Further research with larger sample sizes and subgroup analysis of unilateral and bilateral CLP cases is needed to improve our understanding of these anatomical variations and improve surgical approaches to individuals with CLP undergoing orthognathic procedures.
      (© 2024. The Author(s).)
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    • Contributed Indexing:
      Keywords: Cleft lip palate; Nasal septum osteotomy; Sphenoid sinus
    • Publication Date:
      Date Created: 20240526 Date Completed: 20240526 Latest Revision: 20240529
    • Publication Date:
      20240529
    • Accession Number:
      PMC11129428
    • Accession Number:
      10.1186/s12903-024-04361-z
    • Accession Number:
      38797824