Maxillary sinus recovery and nasal ventilation after Le Fort I osteotomy: a prospective clinical, endoscopic, functional and radiographic evaluation.

The condition of the maxillary sinus is not routinely assessed before a Le Fort I osteotomy. Performing this procedure in an infected sinus might account for a considerable proportion of the complications, such as excessive bleeding and sinusitis. The aim of this study was to evaluate the maxillary sinus and nasal ventilation after Le Fort I osteotomy. Twenty patients were evaluated before and 2 months after surgery using validated questionnaires for sinonasal complaints (RSOM-31 and VAS score), nasal endoscopy, peak nasal inspiratory flow (PNIF), and a computed tomography (CT) scan. There were no differences in complaints before and 2 months after surgery (P>0.24). Also, the PNIF did not change significantly (P=0.10). On CT evaluation before surgery, a previously unnoted sinusitis was diagnosed in two patients. Postoperatively, a thickened sinus mucosa was present in all patients near the osteotomy line, the osteosyntheses, and around sequesters. This report describes maxillary sinus evaluation after Le Fort I osteotomy in a more comprehensive way by using CT. The Le Fort I procedure did not influence already existing physical or mental complaints, and nasal ventilation was not negatively affected. However, evaluation of sinonasal pathology should be emphasized in the preoperative work-up.

[Cough and malaise in young children due to allergic rhinoconjunctivitis]. / Hoesten en malaise bij jonge kinderen, ten gevolge van allergische rinoconjunctivitis.

Four young children (a 6-year-old girl and three boys in the ages of 3.5, 4 and 10 years) with allergic rhinoconjunctivitis were referred with symptoms of cough and general discomfort. Examination revealed signs and symptoms of allergic rhinoconjunctivitis. Blood tests revealed that they were allergic to house dust mite. The symptoms decreased following suitable treatment with antihistamines or nasal corticosteroids. Allergic rhinoconjunctivitis is usually diagnosed in adolescents and adults with symptoms of sneezing, nasal congestion or rhinorrhea and itchy red eyes ('hay fever'). In view of the availability of effective treatment options, it is important to recognise this condition in children who present with cough and malaise.