Leandro Eduardo Klüppel

Incidence of Maxillary Sinusitis Following Le Fort I Osteotomy: Clinical, Radiographic, and Endoscopic Study

PURPOSE The correction of maxillomandibular deformities may require maxillary osteotomy procedures that usually present low rates of postoperative complications, such as maxillary sinusitis. The present study evaluated the incidence of maxillary sinusitis after Le Fort I osteotomy in 21 adult patients who underwent maxillary surgery (Le Fort I osteotomy) or bimaxillary surgery (Le Fort I osteotomy plus sagittal mandibular osteotomies) for correction of dentofacial deformities. PATIENTS AND METHODS Verification of the presence of maxillary sinusitis was assessed through a brief questionnaire, x-rays (Waters views), and nasal endoscopy before surgery and 6 to 8 months after surgery. RESULTS Analysis of results showed an incidence of 4.76% of maxillary sinusitis as a postoperative complication in the studied population. CONCLUSION Symptomatic patients with a positive radiographic finding or an increased risk for postoperative sinusitis will benefit from endoscopic evaluation to aid in treatment planning and follow-up.

Analysis of Incision Effects on Upper Lip Height and Thickness After Maxillary Surgically Assisted Expansion: A Randomized Clinical Trial

PURPOSE To evaluate changes from maxillary circumvestibular incision performed with a #15 scalpel blade versus electrocautery on the height and thickness of the upper lip (UL) after surgically assisted maxillary expansion. MATERIALS AND METHODS Twenty-three patients who underwent surgically assisted maxillary expansion for transverse maxillary deficiency from April 2011 through April 2012 were included in the study. In group 1 (n = 11), the incision was performed with a Bard-Parker #15 scalpel blade. In group 2 (n = 12), the incision was performed with monopolar electrocautery (blend function, 1; power, 20 Watts; frequency, 480 kHz). Clinical measurements for UL height and radiographic measurements for UL height and thickness were performed preoperatively and postoperatively (mean, 6 months). The collected data were subjected to statistical analysis to test the hypotheses of the study. RESULTS After excluding 2 patients, 21 patients were included in the sample. For UL height, clinical and radiographic measurements showed shortening of the UL, and the differences between pre- and postoperative values were statistically significant (P < .05) in the 2 groups. However, there was no statistically significant difference between groups 1 and 2 for UL height (P > .05) by clinical or radiographic measurements. For UL thickness, the 2 groups showed slight UL thickening in the lower portion, with no statistical difference between pre- and postoperative values (P > .05). Moreover, these results were not statistically different between the 2 groups (P = .754). In the uppermost portion of the UL, there was significant thinning in group 2 (P = .001), but not in group 1 (P = .076), and no statistical difference between groups (P = .535). CONCLUSIONS Maxillary circumvestibular incision causes significant shortening of the UL and thinning of the uppermost portion when using a #15 scalpel blade or electrocautery. However, there is no difference in UL dimensional changes when using either technique for maxillary circumvestibular incision.