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.
