# The impact of screw length on postoperative mucosal thickening in le fort i osteotomy

## TL;DR

This study shows that using overly long screws during Le Fort I osteotomy can lead to postoperative nasal mucosal thickening, suggesting that shorter screws may improve surgical outcomes.

## Contribution

The study identifies a specific relationship between excessive screw length and postoperative mucosal thickening after Le Fort I osteotomy.

## Key findings

- 89.5% of screws used exceeded the optimal length, while only 10.5% met recommended criteria.
- Excessive screw length was significantly associated with postoperative mucosal thickening (p = 0.033).
- A 5 mm screw length may offer stable fixation while reducing the risk of sinus mucosal thickening.

## Abstract

This study aimed to determine the optimal screw length in Le Fort I osteotomy and to evaluate its specific relationship with postoperative nasal mucosal thickening.

This retrospective study analyzed 37 patients who underwent Le Fort I osteotomy, either in isolation or in combination with mandibular surgery. Postoperative CT scans were utilized to measure screw lengths and bone widths. Postoperative complications, including maxillary mobility, mucosal thickening, and epiphora due to iatrogenic injury to the nasolacrimal duct, were recorded and analyzed.

The study population consisted of 25 female and 12 male patients, with a mean age of 26.49 ± 6.75 years. Among the 592 screws analyzed, 530 (89.5%) exceeded the optimal length, while only 62 (10.5%) met the recommended criteria. Statistical analysis revealed a significant difference in bone thickness between the piriform and zygomatic buttress regions (p < 0.001). No statistically significant difference in bone thickness was found between males and females. However, there was a significant association between excessive screw length and the occurrence of postoperative mucosal thickening (p = 0.033).

Accurate screw length selection is crucial for reducing postoperative mucosal thickening. A 5 mm screw length may provide stable fixation while reducing the risk of sinus mucosal thickening, potentially contributing to improved surgical outcomes and patient satisfaction.