Tympanometric changes after total maxillary osteotomy

A tympanometric evaluation has been presented using ten patients who had Le Fort I maxillary surgery. Significant changes in middle ear pressure were seen in these patients 24 and 48 hours postoperatively. In three of these patients, otalgias were present that resolved within several days. A similar control group showed no evidence of middle ear abnormalities postoperatively. Possible etiologic factors for the development of abnormal middle ear compliance after maxillary osteotomies include: muscular incoordination, lymphedema within the nasopharynx, predisposing midfacial abnormalities, and nasotracheal intubation. Those patients with a previous history of ear disease are probably susceptible to more severe otologic complications; therefore it is recommended that a complete audiologic and otologic examination precede total maxillary orthognathic surgery. If middle ear disease is found and treated preoperatively, undue pain, discomfort, and middle ear changes could be avoided postoperatively for osteotomized patients.