Department of Oral and Craniomaxillofacial Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University College of Medicine, 639 Zhi-Zao-Ju Road, Shanghai, 200011, China.
Shanghai Key Laboratory of Stomatology, Shanghai, China.
Aesthetic Plast Surg. 2022 Aug;46(4):1731-1737. doi: 10.1007/s00266-022-02854-2. Epub 2022 Apr 22.
Dento-maxillofacial deformities are often associated with nasal deviation, and patients often complain of nasal deviation after orthognathic surgery. This study aimed to quantitatively evaluate the facial visual attention given to dento-maxillofacial deformities accompanying nasal deviation from the perspective of patients and determine whether orthognathic surgery could alter this outcome.
The scanning paths of 137 patients were recorded using an eye-tracking device; recordings were made while the patients viewed images of dento-maxillofacial deformities associated with various degrees of nasal deviation before or after orthognathic surgery. Visual attention focused on the lower face and nose was analyzed.
When viewing postoperative faces, the participants focused more visual attention on noses and less on the lower face than they did on preoperative faces. Interestingly, for preoperative faces, nasal deviation could significantly increase participants' visual attention to the lower face, and visual attention to noses was significantly increased when noses were deviated 12°, while for postoperative faces, a nasal deviation of 4° or more was associated with a significant increase in participants' visual attention to the nose.
Patients tended to focus their visual attention on the lower region of preoperative faces and ignored nose irregularities. Orthognathic surgery can alter visual attention, shifting it from the lower face to the nose, and a deviation of 4° or more could be a potential concern for patients. Clinicians must inform patients preoperatively about preexisting nasal deviations, which can guide surgical planning and help manage patient expectations.
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牙颌面畸形常伴有鼻偏斜，患者常抱怨正颌手术后出现鼻偏斜。本研究旨在从患者角度定量评估伴有鼻偏斜的牙颌面畸形的面部视觉注意力，并确定正颌手术是否可以改变这种结果。
使用眼动追踪装置记录 137 名患者的扫描路径；在患者观看正颌术前或术后不同程度伴发鼻偏斜的牙颌面畸形图像时进行记录。分析对下脸和鼻子的视觉注意力。
当观看术后面部时，参与者比术前面部更关注鼻子，而较少关注下脸。有趣的是，对于术前面部，鼻偏斜可以显著增加参与者对下脸的视觉注意力，当鼻子偏斜 12°时，对鼻子的视觉注意力显著增加，而对于术后面部，4°或更大的鼻偏斜与参与者对鼻子的视觉注意力显著增加相关。
患者倾向于将视觉注意力集中在下半张术前面部，而忽略了鼻子的不规则。正颌手术可以改变视觉注意力，将其从下脸转移到鼻子，4°或更大的偏斜可能是患者关注的潜在问题。临床医生必须在术前告知患者存在的鼻偏斜，这可以指导手术计划，并帮助管理患者的期望。
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