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J Plast Reconstr Aesthet Surg ; 74(3): 592-604, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33041238

RESUMO

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.


Assuntos
Maxila , Nariz , Procedimentos Cirúrgicos Ortognáticos , Osteotomia de Le Fort , Modelagem Computacional Específica para o Paciente , Adulto , Tomografia Computadorizada de Feixe Cônico/métodos , Feminino , Humanos , Imageamento Tridimensional/métodos , Masculino , Maxila/diagnóstico por imagem , Maxila/cirurgia , Nariz/diagnóstico por imagem , Nariz/patologia , Procedimentos Cirúrgicos Ortognáticos/efeitos adversos , Procedimentos Cirúrgicos Ortognáticos/métodos , Osteotomia de Le Fort/efeitos adversos , Osteotomia de Le Fort/métodos , Fotogrametria/métodos , Cuidados Pré-Operatórios/métodos , Período Pré-Operatório , Reprodutibilidade dos Testes
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