Postoperative Alterations in Maxillary Sinus Health Following Le Fort I Osteotomy: A CBCT-Based Retrospective Study

Background and Aim: The Le Fort I osteotomy is often used to address maxillomandibular discrepancies and might affect maxillary sinus health because of its proximity to the maxillary sinuses. This study aimed to evaluate postoperative alterations in maxillary sinus membrane thickness, osteomeatal patency, and the development of secondary nasoantral ostium using cone-beam computed tomography (CBCT). Materials and Methods: This retrospective study involved 28 patients (17 females, 11 males) who underwent Le Fort I osteotomy at Hacettepe University from 2013 to 2023. Preoperative and postoperative CBCT scans taken between 6 and 24 months after surgery were analyzed to measure the Schneiderian membrane (SM) thickness, determine thickening grades and patterns, and assess osteomeatal patency and secondary ostium formation. Statistical analyses were performed using the Wilcoxon signed-rank, Mann–Whitney U, and McNemar tests, with a significance level of p<0.05. Results: Median SM thickness significantly increased postoperatively from 0.75 mm (IQR:0.50–4.37) to 2.60 mm (IQR:0.62–6.97) (p=0.016). Sinuses associated with fixation materials and bone substitutes showed markedly greater thickening (median 8.16 mm, p<0.001). The distribution of thickening grades and patterns shifted slightly toward higher severity, though not significantly. Postoperative obstruction of the osteomeatal complex was observed in 4 sinuses (7.14%), and a secondary nasoantral ostium developed in 5 sinuses (8.92%). Conclusion: Le Fort I osteotomy may lead to persistent postoperative thickening of the maxillary sinus membrane, particularly near surgical materials. Although minor changes in sinus health were observed, the formation of secondary ostia and osteomeatal obstruction highlight the importance of longterm radiological monitoring following orthognathic surgery.