Simultaneous Functional Endoscopic Sinus Surgery and Esthetic Rhinoplasty in Orthognathic Patients

Costa, Fabio; Robiony, Massimo; Salvo, Iolanda; Toro, Corrado; Sembronio, Salvatore; Politi, Massimo

doi:10.1016/j.joms.2008.01.008

« Previous Next »Journal of Oral and Maxillofacial Surgery
Volume 66, Issue 7 , Pages 1370-1377, July 2008

Simultaneous Functional Endoscopic Sinus Surgery and Esthetic Rhinoplasty in Orthognathic Patients

Fabio Costa, MD
- Consultant in Maxillofacial Surgery, Department of Maxillofacial Surgery, University of Udine, Udine, Italy.
- Address correspondence and reprint requests to Dr Costa: Clinica di Chirurgia Maxillo-Facciale, Azienda Ospedaliero Universitaria, P.le S. Maria della Misericordia, 33100 Udine, Italy
Massimo Robiony, MD, FEBOMFS
- Associate Professor of Maxillofacial Surgery, Department of Maxillofacial Surgery, University of Udine, Udine, Italy.
Iolanda Salvo, MD
- Attender at the Clinic of Maxillofacial Surgery, Department of Maxillofacial Surgery, University of Udine, Udine, Italy.
Corrado Toro, MD
- PhD Researcher, Department of Maxillofacial Surgery, University of Udine, Udine, Italy.
Salvatore Sembronio, MD
- PhD Researcher, Department of Maxillofacial Surgery, University of Udine, Udine, Italy.
Massimo Politi, MD, DMD
- Dean of the Faculty of Medicine and Professor of Maxillofacial Surgery, Head of the Department of Maxillofacial Surgery, University of Udine, Udine, Italy.

Purpose

Patients treated for dentofacial deformities may be predisposed to aggravated sinonasal disease postoperatively, particularly if concurrent rhinoplasty is performed. The authors present their experience with simultaneous rhinoplasty, maxillary/mandibular osteotomies, and functional endoscopic sinus surgery (FESS).

Patients and Methods

Thirteen patients were treated with simultaneous rhinoplasty, maxillary/mandibular osteotomies, and FESS from January 2002 to December 2005. An operative algorithm for patients with dentofacial deformities requiring rhinoplasty was developed. The surgical procedure was performed under general anesthesia with nasotracheal intubation and maxillary/mandibular osteotomies first. Nasotracheal intubation was then converted to orotracheal intubation and FESS was performed. The third step was correction of the esthetic deformities of the nose through an open approach.

Results

In all cases, it was possible to successfully complete the combined operation. Median operation time was: 2 hours and 18 minutes for orthognathic bimaxillary surgery, 54 minutes for rhinoplastic surgery; and 23 minutes for FESS. All the patients had good esthetic and functional results and were free from symptoms consistent with previous rhinosinusitis.