Nasal Airway Function After Maxillary Surgery: A Prospective Cohort Study Using the Nasal Obstruction Symptom Evaluation Scale

Purpose To examine nasal airway function using a disease-specific quality-of-life survey instrument in subjects undergoing Le Fort I osteotomy without simultaneous rhinosurgical procedures. Materials and Methods We conducted a prospective cohort study of nasal airway function in consecutive Le Fort I osteotomy patients, who had not received simultaneous rhinosurgical procedures, between 2007 and 2008 at Kaiser Permanente Oakland Medical Center. We administered the Nasal Obstruction Symptom Evaluation (NOSE) survey before and 3 months after surgery. Clinical and radiographic examinations were performed, and the relevant medical and demographic factors were analyzed. Results The initial study sample comprised 55 patients, of whom 5 were excluded. Of the remaining 50 patients (median age 21 years, 60% women), the maxilla was advanced (median 4 mm, interquartile range 3 to 5) with minimal vertical change. During the follow-up period (median 5.5 months), significant improvement was seen in the NOSE scores for the cohort, with a median decrease of 10 units ( P = .0005). Patients with moderate nasal obstruction (preoperative NOSE score >25) had the greatest improvement ( P 50) improved, however, this did not reach statistical significance ( P Conclusions Our overall findings have suggested that nasal airway function improved after maxillary advancement and that subjects with greater preoperative NOSE scores (>25) were more likely to experience relief of nasal obstructive symptoms.