Esenlik Elçin, Kaya Basar, Gülsen Ayse, Çukurluoğlu Onur, Özmen Selahattin, Yavuzer Reha
Department of Orthodontics, Faculty of Dentistry, Süleyman Demirel University, Ankara, Turkey.
J Craniofac Surg. 2011 Nov;22(6):2072-9. doi: 10.1097/SCS.0b013e3182319959.
The aim of this study was to identify and quantify nasal profile changes following maxillary advancement (MA) and maxillary advancement with impaction (MAI) with Le Fort I osteotomies.
The study consisted of preoperative and postoperative lateral cephalograms of 42 class III adult patients. The study sample was divided into 2 groups, with the first group composed of 22 patients who underwent MA surgery and the second group composed of 20 patients who underwent MAI surgery. In total, 7 skeletal parameters and 17 soft-tissue parameters related to nasal projection, hump, dorsal convexity, and the nasolabial region were evaluated on the cephalograms, and hard- and soft-tissue relationships were assessed.
Nasal length, hump, nasal depths, distance from the most convex point of the Alar curvature to the most inferior point of the nostril, alar curvature-subnasale, and subnasale-pronasale measurements decreased postoperatively. In the MAI group, MA correlated with significant decreases in nasal length and hump. In the MA group, MA correlated with pronasale position (P < 0.05); significant decreases in nasal depth, columella convexity, and subnasale-pronasale length; and significant changes in subnasale position.
There is little difference in the effects of the 2 different maxillary surgeries on the postoperative nasal profile.
本研究的目的是确定并量化采用勒福Ⅰ型截骨术进行上颌前徙（MA）和上颌前徙伴骨块植入（MAI）后鼻外形的变化。
该研究包括42例Ⅲ类成年患者的术前和术后头颅侧位片。研究样本分为2组，第一组由22例行MA手术的患者组成，第二组由20例行MAI手术的患者组成。总共在头颅侧位片上评估了7个骨骼参数和17个与鼻突度、鼻背、鼻背凸度及鼻唇区域相关的软组织参数，并评估了软硬组织关系。
术后鼻长度、鼻背、鼻深度、鼻翼曲线最凸点至鼻孔最下点的距离、鼻翼曲线-鼻下点、鼻下点-鼻前棘测量值均减小。在MAI组中，上颌前徙与鼻长度和鼻背的显著减小相关。在MA组中，上颌前徙与鼻前棘位置相关（P<0.05）；鼻深度、鼻小柱凸度和鼻下点-鼻前棘长度显著减小；鼻下点位置有显著变化。
两种不同的上颌手术对术后鼻外形的影响差异不大。
