Effect of Orthognathic Surgery Associated or Not with Nasal Procedures on Breathing in Cleft Palate Individuals
Introduction: Orthognathic surgery with maxillary advancement (OSMA) promotes aesthetic and functional benefits by modifying the orofacial structures position. In patients with cleft lip and palate, the procedure can lead to improved breathing by the nasopharyngeal space increasing thus promoting nasal breathing due to the maxillary advancement and by the possibility of verticalization of the nasal septum.
Objectives: To compare the effect of orthognathic surgery associated or not with nasal procedures on nasal patency through instrumental evaluation.
Methods: Comparative analysis of the dimension of the minimum cross-sectional area of the nasal cavity (nasal area) determined by the pressure-flow technique in 160 patients with repaired cleft lip and palate submitted to OSMA. All participants underwent orthognathic surgery and were evaluated 18 months after surgery. The patients were divided into two groups: Group 1 = 80 patients submitted to OSMA associated with nasal procedures and Group 2 = 80 patients submitted to OSMA without nasal procedures. The nasal area considered for the analysis was obtained by the sum of the right and left nasal areas. Statistical analysis was performed using the T test for independent samples, with a significance level of 5%.
Results: The mean (±SD) values of nasal area were 0.676 (± 0.163) cm2 for Group 1 and 0.623 (± 0.170) cm2 for Group 2. Statistical analysis showed that the mean nasal area of Group1 was significantly higher than Group 2 (p < 0.05).
Conclusion: OSMA leads to the increase of the nasal area and thus increases nasal patency. The results are more significant when associated to nasal procedures.
Keywords: Cleft palate, orthognathic surgery, pressure-flow technique.