Author(s)
Cameron B. Lindemann, DO
Avori Bastemeyer MSIV
Aaron Rochester, DO Michael Eliason, MD
Affiliation(s)
Naval Medical Center Portsmouth;
Abstract:
Introduction:
LeFort I osteotomies are performed with the intent to correct dental occlusal abnormalities. Anatomical shifts resulting from these procedures may lead to vector changes of the muscles surrounding the eustachian tube. In our practice, we have observed patients reporting symptoms consistent with eustachian tube dysfunction (ETD) following LeFort I orthognathic surgery.
Methods:
Based on this clinical experience and proposed anatomical changes, we hypothesized an increased incidence of ETD in patients undergoing LeFort I orthognathic surgery. We conducted a prospective cohort study to evaluate the occurrence of new-onset ETD following LeFort I orthognathic surgery. Adult patients who were recommended to have LeFort I orthognathic surgery were included in the study. The validated Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7) was administered as the primary outcome measure prior to and following surgery. Multivariate analysis was performed to stratify the data based on age, race, and gender.
Results:
Preliminary analysis suggests no significant change in incidence of ETD following LeFort I surgery. Pre-operative mean item score average was 1.97, with postoperative mean item score average being 1.79, an overall decrease, not reaching statistical significance. As the study is ongoing, multivariate analysis has been postponed as further data is collected.
Conclusions: ?LeFort I osteotomes are commonly performed to improve dental occlusal abnormalities. Major anatomic shifts of the mid face may result in many unintended physiologic changes. We hypothesized that advancing the maxilla relative to the skull base could theoretically change the orientation of the eustachian tube, and thus, decrease its functionality. However, our preliminary results do not support this. Further data should be collected in this realm to adequately analyze this relationship to properly counsel patients who receive LeFort surgery.