Long-term Effects of Le Fort I Osteotomy for Resection of Juvenile Nasopharyngeal Angiofibroma on Maxillary Growth and Dental Sensation | Oncology | JAMA Otolaryngology–Head & Neck Surgery | JAMA Network
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Original Article
August 2002

Long-term Effects of Le Fort I Osteotomy for Resection of Juvenile Nasopharyngeal Angiofibroma on Maxillary Growth and Dental Sensation

Author Affiliations

From the Department of Surgery, Section of Otolaryngology, Yale School of Medicine (Drs Lowlicht and Sasaki), and the Department of Otolaryngology, Yale–New Haven Medical Center (Dr Jassin), New Haven, Conn. Dr Kim is in private practice in Hamden, Conn.

Arch Otolaryngol Head Neck Surg. 2002;128(8):923-927. doi:10.1001/archotol.128.8.923
Abstract

Objective  To analyze the long-term effects of the Le Fort I osteotomy approach for the resection of juvenile nasopharyngeal angiofibroma (JNA) on maxillary growth and dental sensation.

Design  Prospective collection of structured data.

Setting  Tertiary care academic teaching hospital.

Patients  Between 1993 and 1998, 5 adolescents (aged 10-14 years) constituted the evaluable cohort among 14 patients who underwent Le Fort I osteotomy for JNA resection. Mean follow-up was 47.2 months.

Interventions  The Le Fort I osteotomy approach was used to resect JNA. Cephalometric x-ray films were taken at various postoperative intervals to assess maxillary growth. The results were matched against age-correlated predictions from Dentofacial Planner software.

Main Outcome Measures  Horizontal and vertical maxillary growth were each measured anteriorly and posteriorly by comparing interval postoperative cephalometric x-ray films. Dental sensation was longitudinally evaluated by performing interval pulp testing postoperatively.

Results  (1) Average vertical growth of the maxilla achieved 30% of predicted growth anteriorly (P = .02). (2) Average horizontal growth matched predicted growth in all patients. (3) All patients demonstrated long-term maxillary dental denervation.

Conclusions  Le Fort I osteotomy provides excellent surgical exposure for resection of JNA in the growing facial skeleton. Although it significantly affects vertical but not horizontal growth, its cosmetic effect is negligible. It also causes long-term dental denervation, which in most cases is undetected by patients.

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