Internal structural analysis of the nasomaxillary complex in patients with skeletal class III asymmetry: A study on asymmetry patterns

Orthod Craniofac Res. 2024 Jun;27(3):376-386. doi: 10.1111/ocr.12739. Epub 2023 Dec 6.

Abstract

Objectives: To investigate the internal structure of the nasomaxillary complex, including the maxillary sinus, nasal cavity and nasal septum according to the facial asymmetry pattern and to evaluate its correlation with external maxillomandibular asymmetry in Class III patients based on cone-beam computerized tomography (CBCT) images.

Materials and methods: Facial asymmetry was analysed in a total of 100 Class III patients aged 16 years or older using CBCT scans. Patients were categorized into subgroups based on asymmetry pattern. Measurements of the nasomaxillary complex were obtained from the CBCT scans, including the volume and width of the maxillary sinuses and nasal cavities on deviated and non-deviated sides, as well as the displacement of the nasal septum. Statistical analysis was performed to compare the internal nasomaxillary variables within and between groups, and regression analysis was conducted to evaluate the correlation between facial asymmetry and the internal nasomaxillary variables.

Results: Group comparisons showed that there were no significant differences in the volume of the maxillary sinus and nasal cavity. However, the direction and extent of nasal septum deviation, as well as the width of the nasal cavity, varied depending on the maxillary asymmetry pattern. Regression analysis indicated a correlation between nasal septum deviation and the difference in maxillary height, while the difference in nasal cavity width was correlated with the difference in maxillary width.

Conclusion: A comprehensive evaluation of the internal nasal anatomy is vital for understanding the intricate relationship between nasal structure and maxillary growth.

Keywords: CBCT; maxillary asymmetry pattern; nasal cavity width; nasal septum deviation; nasomaxillary complex.

MeSH terms

  • Adolescent
  • Adult
  • Cephalometry
  • Cone-Beam Computed Tomography*
  • Facial Asymmetry* / diagnostic imaging
  • Facial Asymmetry* / pathology
  • Female
  • Humans
  • Male
  • Malocclusion, Angle Class III* / diagnostic imaging
  • Malocclusion, Angle Class III* / pathology
  • Maxilla* / diagnostic imaging
  • Maxilla* / pathology
  • Maxillary Sinus* / anatomy & histology
  • Maxillary Sinus* / diagnostic imaging
  • Maxillary Sinus* / pathology
  • Nasal Cavity* / anatomy & histology
  • Nasal Cavity* / diagnostic imaging
  • Nasal Cavity* / pathology
  • Nasal Septum* / abnormalities
  • Nasal Septum* / diagnostic imaging
  • Nasal Septum* / pathology
  • Young Adult