Metzler Philipp, Geiger Erik J, Chang Christopher C, Steinbacher Derek M
Craniofacial Fellow, Department of Plastic and Reconstructive Surgery, Yale University School of Medicine, New Haven, CT.
Student, Department of Plastic and Reconstructive Surgery, Yale University School of Medicine, New Haven, CT.
J Oral Maxillofac Surg. 2014 Oct;72(10):2005-14. doi: 10.1016/j.joms.2014.03.004. Epub 2014 Mar 13.
The impact of surgically assisted maxillary expansion (SAME) on facial soft tissue structures has not been adequately studied using 3-dimensional (3D) objective analysis. The purpose of this study was to analyze nasolabial soft tissue after SAME using 3D photographic technology.
This was a retrospective cohort study of patients undergoing SAME in which pre- and postexpansion 3D photographs (3D VECTRA Photosystem, Canfield, Fairfield, NJ) were analyzed. Nasolabial anthropometric measurements were performed using the 3D postprocessing software (Mirror). A follow-up period of at least 6 months was required for final evaluation. Two observers verified the landmarks on each dataset before measuring. Statistical analysis involved the paired t test, the Simes correction for multiple comparisons, and repeated measures analysis of covariance (ANCOVA) to control for age, gender, and the time lag between pre- and postoperative assessments.
Twelve patients (24 photogrammetric datasets) were included. The male-to-female ratio was 0.5 (mean age, 17.3 yr). Nasal changes after SAME showed significant increases (P < .05) in alar width (from 33.1 to 34.5 mm), sill width (from 9.2 to 9.7 mm), and columella projection (from 94.1 to 95.1 mm) after the Simes correction. ANCOVA showed a significant increase in alar base width. Distinct changes in nostril shape and dimension were found, but lacked statistical significance.
Three-dimensional analysis shows widening of the alar width and alar base width after SAME. The magnitude of nasal change parallels that of expansion at the piriform aperture.
采用三维(3D)客观分析方法对手术辅助上颌扩弓(SAME)对面部软组织结构的影响尚未进行充分研究。本研究的目的是使用3D摄影技术分析SAME术后的鼻唇软组织情况。
这是一项对接受SAME治疗患者的回顾性队列研究,分析扩弓前后的3D照片(3D VECTRA照相系统,Canfield,费尔菲尔德,新泽西州)。使用3D后处理软件(Mirror)进行鼻唇人体测量。最终评估需要至少6个月的随访期。两名观察者在测量前核实每个数据集中的标志点。统计分析包括配对t检验、用于多重比较的西姆斯校正以及重复测量协方差分析(ANCOVA),以控制年龄、性别以及术前和术后评估之间的时间间隔。
纳入12例患者(24个摄影测量数据集)。男女比例为0.5(平均年龄17.3岁)。SAME术后鼻部变化显示,经西姆斯校正后,鼻翼宽度(从33.1毫米增加到34.5毫米)、鼻槛宽度(从9.2毫米增加到9.7毫米)和鼻小柱突出度(从94.1毫米增加到95.1毫米)有显著增加(P < .05)。ANCOVA显示鼻翼基部宽度有显著增加。发现鼻孔形状和尺寸有明显变化,但缺乏统计学意义。
三维分析显示SAME术后鼻翼宽度和鼻翼基部宽度增宽。鼻部变化的幅度与梨状孔扩弓的幅度相当。