Introduction: The aim of this study was to define the difference between lateral nasal wall anatomy and variations as linear and angular in patients with class II and class III dentofacial deformities and to determine a surgical margin for safe entry by establishing an ideal osteotomy line for lateral nasal wall osteotomy during Le Fort I surgery. Materials and Methods: Eighty-five patients with dentofacial deformities, who were admitted to Medipol Mega University Hospital between September 2018 and February 2021, and 170 regions, including the right and left, were evaluated. In the axial image taken from coronal sections 5 mm above the deepest point of the nasal floor, lateral nasal wall angulations and linear and angular distances to the descending palatine canal were measured. Class II and class III patients were evaluated according to the right and left regions and gender. Results: The angled right distance values to the descending palatine artery of class III patients are higher than the values of the angled left distance to the descending palatine canal (p = 0.034). The right second angulation levels of class II female patients are higher than those of class II male patients (p = 0.037). Class III male patients have a significantly higher right linear distance to the descending palatine canal and right second angulation levels compared to class III female patients (p1 = 0.009; p2 = 0.003). The right second angulation levels of class II male patients are significantly lower than those of class III male patients (p = 0.003). Conclusion: This study described the mean angulations and linear distances between anatomic structures of the lateral nasal wall in patients with class II and class III dentofacial deformities for the purpose of a safe osteotomy. The location of the descending palatine canal and the morphology of the lateral nasal wall are not significantly associated with dentofacial deformity.

1.
Kotaniemi
KVM
,
Suojanen
J
,
Palotie
T
.
Peri-and postoperative complications in Le Fort I osteotomies
.
J Craniomaxillofac Surg
.
2021
;
49
(
9
):
789
798
.
2.
Eshghpour
M
,
Mianbandi
V
,
Samieirad
S
.
Intra-and postoperative complications of Le Fort I maxillary osteotomy
.
J Craniofac Surg
.
2018
;
29
(
8
):
e797
803
.
3.
Ueki
K
,
Nakagawa
K
,
Marukawa
K
,
Yamamoto
E
.
Le Fort I osteotomy using an ultrasonic bone curette to fracture the pterygoid plates
.
J Craniomaxillofac Surg
.
2004
;
32
(
6
):
381
6
.
4.
Hoffman
GR
,
Islam
S
.
The difficult Le Fort I osteotomy and downfracture: a review with consideration given to an atypical maxillary morphology
.
J Plast Reconstr Aesthet Surg
.
2008
;
61
(
9
):
1029
33
.
5.
Li
KK
,
Meara
JG
,
Alexander
A
Jr
.
Location of the descending palatine artery in relation to the Le Fort I osteotomy
.
J Oral Maxillofac Surg
.
1996
;
54
(
7
):
822
5
; discussion 826–7. https://doi.org/10.1016/s0278-2391(96)90528-5.
6.
Lanigan
DT
,
Hey
JH
,
West
RA
.
Major vascular complications of orthognathic surgery: hemorrhage associated with Le Fort I osteotomies
.
J Oral Maxillofac Surg
.
1990
;
48
(
6
):
561
73
.
7.
Cortese
A
.
Le Fort I osteotomy for maxillary repositioning and distraction techniques
.
Maastricht, The Netherlands
:
Institute for New Technologies
;
2012
.
8.
Pereira
FL
,
Yaedú
RYF
,
Sant’Ana
AP
,
Sant’Ana
E
.
Maxillary aseptic necrosis after Le Fort I osteotomy: a case report and literature review
.
J Oral Maxillofac Surg
.
2010
;
68
(
6
):
1402
7
.
9.
Nelson
RL
,
Path
MG
,
Ogle
RG
,
Waite
DE
,
Meyer
MW
.
Quantitation of blood flow after Le Fort I osteotomy
.
J Oral Surg
.
1977
;
35
(
1
):
10
6
.
10.
Dodson
TB
,
Bays
RA
,
Neuenschwander
MC
.
Maxillary perfusion during Le Fort I osteotomy after ligation of the descending palatine artery
.
J Oral Maxillofac Surg
.
1997
;
55
(
1
):
51
5
.
11.
Lanigan
DT
,
Hey
JH
,
West
RA
.
Aseptic necrosis following maxillary osteotomies: report of 36 cases
.
J Oral Maxillofac Surg
.
1990
;
48
(
2
):
142
56
.
12.
Fernández-Prieto
A
,
Garcı́a-Raya
P
,
Burgueño
M
,
Muñoz-Caro
J
,
Frutos
R
.
Endovascular treatment of a pseudoaneurysm of the descending palatine artery after orthognathic surgery: technical note
.
Int J Oral Maxillofac Surg
.
2005
;
34
(
3
):
321
3
.
13.
Suzen
M
,
Temiz
M
,
Demirel
O
,
Uckan
S
.
Surgical protocol for a safe lateral nasal wall osteotomy
.
J Craniofac Surg
.
2020
;
31
(
3
):
853
5
.
14.
Cheung
LK
,
Fung
SC
,
Li
T
,
Samman
N
.
Posterior maxillary anatomy: implications for Le Fort I osteotomy
.
Int J Oral Maxillofac Surg
.
1998
;
27
(
5
):
346
51
.
15.
Ueki
K
,
Hashiba
Y
,
Marukawa
K
,
Nakagawa
K
,
Okabe
K
,
Yamamoto
E
.
Determining the anatomy of the descending palatine artery and pterygoid plates with computed tomography in Class III patients
.
J Craniomaxillofac Surg
.
2009
;
37
(
8
):
469
73
.
16.
Oliveira
GQV
,
Rossi
MA
,
Vasconcelos
TV
,
Neves
FS
,
Crusoé-Rebello
I
.
Cone beam computed tomography assessment of the pterygomaxillary region and palatine canal for Le Fort I osteotomy
.
Int J Oral Maxillofac Surg
.
2017
;
46
(
8
):
1017
23
.
17.
Apinhasmit
W
,
Chompoopong
S
,
Methathrathip
D
,
Sangvichien
S
,
Karuwanarint
S
.
Clinical anatomy of the posterior maxilla pertaining to Le Fort I osteotomy in Thais
.
Clin Anat
.
2005
;
18
(
5
):
323
9
.
You do not currently have access to this content.