Le Fort I 上颌骨复位对三维鼻尖旋转的影响：亚洲鼻的相关比较研究
Effect of Le Fort I Maxillary Repositioning on Three-Dimensional Nasal Tip Rotation: A Comparative Study with Implication for the Asian Nose.
机构信息
From the Departments of Plastic and Reconstructive Surgery and Craniofacial Orthodontics and the Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University; and the Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital.
出版信息
Plast Reconstr Surg. 2021 Apr 1;147(4):903-914. doi: 10.1097/PRS.0000000000007774.
BACKGROUND
Le Fort I maxillary repositioning influences nasal morphology. In Asian cultures, upward nasal tip rotation with increased nostril exposure is considered aesthetically unpleasant and can have psychosocial consequences. This three-dimensional imaging-based study evaluated the effect of different Le Fort I maxillary movements on nasal tip rotation.
METHODS
Consecutive patients who underwent two-jaw orthognathic surgery (n = 107) were enrolled. To achieve a standard head orientation, preoperative and 1-week and 12-month postoperative cone-beam computed tomography-derived three-dimensional craniofacial models were superimposed. Tip rotation angle was calculated according to the Frankfort horizontal plane for all three-dimensional digital models. The final tip rotation angle change was defined as 12-month postoperative value minus preoperative value. Translational maxillary movement types (advancement versus setback and intrusion versus extrusion), postoperative maxillary segment locations (anterosuperior, anteroinferior, posterosuperior, or posteroinferior), and actual linear maxillary changes were noted.
RESULTS
Advancement (1.79 ± 5.20 degrees) and intrusion (2.23 ± 4.96 degrees) movements demonstrated significantly larger final tip rotation angle changes than setback (-0.88 ± 5.15 degrees) and extrusion (0.09 ± 5.44 degrees) movements (all p < 0.05). Postoperative anterosuperior location (2.95 ± 4.52 degrees) of the maxillary segment demonstrated a significantly larger final tip rotation angle change than anteroinferior (0.48 ± 5.65 degrees), posterosuperior (-1.08 ± 4.77 degrees), and posteroinferior (-0.64 ± 5.80 degrees) locations (all p < 0.05). Translational maxillary movement and actual linear maxillary change were not correlated with final tip rotation angle change.
CONCLUSION
Effects of Le Fort I maxillary repositioning on nasal tip rotation depend on movement types and maxillary segment location.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
背景
Le Fort I 上颌骨复位会影响鼻形态。在亚洲文化中，人们认为向上旋转鼻尖并增加鼻孔显露会影响美感，并可能带来心理社会后果。本项基于三维成像的研究评估了不同 Le Fort I 上颌骨移动对上鼻尖旋转的影响。
方法
连续纳入接受双颌正颌手术的患者（n = 107）。为了实现标准的头部取向，将术前和术后 1 周及 12 个月的锥形束 CT 衍生的三维颅面模型进行叠加。根据法兰克福水平面计算所有三维数字模型的鼻尖旋转角度。最终鼻尖旋转角度变化定义为术后 12 个月值减去术前值。记录了上颌骨的平移运动类型（前突、后缩、内收、外展）、术后上颌骨段位置（前上、前下、后上、后下）和实际的上颌骨线性变化。
结果
前突（1.79 ± 5.20 度）和内收（2.23 ± 4.96 度）运动的最终鼻尖旋转角度变化明显大于后缩（-0.88 ± 5.15 度）和外展（0.09 ± 5.44 度）运动（均 p < 0.05）。上颌骨段的术后前上位置（2.95 ± 4.52 度）的最终鼻尖旋转角度变化明显大于前下（0.48 ± 5.65 度）、后上（-1.08 ± 4.77 度）和后下（-0.64 ± 5.80 度）位置（均 p < 0.05）。平移上颌骨运动和实际的上颌骨线性变化与最终鼻尖旋转角度变化无关。
结论
Le Fort I 上颌骨复位对上鼻尖旋转的影响取决于运动类型和上颌骨段位置。
临床问题/证据水平：治疗性，III 级。
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