Type of maxillary segment mobilization affects three-dimensional nasal morphology

J Plast Reconstr Aesthet Surg. 2021 Mar;74(3):592-604. doi: 10.1016/j.bjps.2020.08.119. Epub 2020 Sep 20.

Abstract

Background: Surgical mobilization of the maxillary segment affects nasal morphology. This study assessed the impact of the type of maxillary mobilization on the three-dimensional (3D) nasal morphometry.

Methods: Pre- and postsurgery cone beam computed tomography-derived facial image datasets of consecutive patients who underwent two-jaw orthognathic surgery were reviewed. Using preoperative 3D facial models as the positional reference of the skeletal framework, 12-month postoperative 3D facial models were classified into four types of maxillary mobilizations (advancement [n = 83], setback [n = 24], intrusion [n = 55], and extrusion [n = 52]) and four types of final maxillary positions (anterosuperior [n = 44], anteroinferior [n = 39], posterosuperior [n = 11], and posteroinferior [n = 13]). Six 3D soft tissue nasal morphometric parameters were measured, with excellent intra- and interexaminer reliability scores (ICC>0.897) for all the measurements. The 3D nasal change for each nasal parameter was computed as the difference between postoperative and preoperative measurement values.

Results: The intrusion maxillary mobilization resulted in a significantly (all p<0.05) larger 3D nasal change in terms of alar width, alar base width, and nostril angle parameters, and a smaller change in terms of the nasal tip height parameter than the extrusion maxillary mobilization; however, no significant (all p>0.05) difference was observed between advancement and setback maxillary mobilizations. The anterosuperior and posterosuperior maxillary positions had a significantly (all p<0.05) larger 3D nasal change in terms of the alar base width and nostril angle than the anteroinferior and posteroinferior maxillary positions.

Conclusion: The type of maxillary mobilization affects the 3D nasal morphometry.

Keywords: Le Fort I; Maxillary; Nasal morphometry; Surgical mobilization.

MeSH terms

  • Adult
  • Cone-Beam Computed Tomography / methods
  • Female
  • Humans
  • Imaging, Three-Dimensional / methods
  • Male
  • Maxilla* / diagnostic imaging
  • Maxilla* / surgery
  • Nose* / diagnostic imaging
  • Nose* / pathology
  • Orthognathic Surgical Procedures* / adverse effects
  • Orthognathic Surgical Procedures* / methods
  • Osteotomy, Le Fort* / adverse effects
  • Osteotomy, Le Fort* / methods
  • Patient-Specific Modeling*
  • Photogrammetry / methods
  • Preoperative Care / methods
  • Preoperative Period
  • Reproducibility of Results