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分析 Le Fort I 截骨术后的下鼻甲形态和鼻孔。

Analysis of Inferior Nasal Morphology and Nostrils following Le Fort I Osteotomy.

机构信息

Department of Oral and Maxillofacial Surgery, School of Dentistry, İstanbul Medipol University, Istanbul, Turkey.

出版信息

J Craniofac Surg. 2022;33(8):2682-2687. doi: 10.1097/SCS.0000000000008829. Epub 2022 Aug 1.

Abstract

OBJECTIVE

This study aimed to investigate the soft tissue parameters related to inferior nasal morphology and nostril shape and investigate the change at nostril types according to the Modified Topinard System following maxillary surgery.

MATERIALS AND METHODS

Thirty-five patients who underwent Le Fort I osteotomy with or without mandibular osteotomy were included in this retrospective study. Presurgery (T1) and postsurgery (T2) measurements which were the angle between the longitudinal axis of left and right nostril, nostril length, nostril width, alar width, alar base width, columella length, and columella width, were measured on computed tomography images. Nostril types according to Modified Topinard System and nostril shapes were also examined.

RESULTS

Following Le Fort I surgery, there was a significant increase in alar base width, alar width, and angle between the longitudinal axis of the left and right nostril (P<0.05). Nasal tip protrusion was decreased with significance (P=0.022). Multiple linear regression analysis showed that every 1 mm maxillary impaction amount leads to a 3.34° increase in the angle between the longitudinal axis of the left and right nostrils (P=0.03, adjusted R2=0.21). Nostril type classification according to Modified Topinard System was changed significantly (P=0.000).

CONCLUSION

Surgeons should be aware of the risk of postoperative nonaesthetic results in Modified Topinard System's borderline cases. Modified Topinard classification may be included in preoperative orthognathic planning from the bottom view.

摘要

目的

本研究旨在探讨与下鼻甲形态和鼻孔形状相关的软组织参数,并研究上颌骨手术后根据改良 Topinard 系统,鼻孔类型的变化。

材料和方法

本回顾性研究纳入了 35 例接受 Le Fort I 截骨术伴或不伴下颌骨截骨术的患者。在计算机断层扫描图像上测量术前(T1)和术后(T2)的测量值,包括左右鼻孔的纵轴之间的角度、鼻孔长度、鼻孔宽度、鼻翼宽度、鼻翼基底宽度、鼻中隔长度和鼻中隔宽度。还根据改良 Topinard 系统检查了鼻孔类型和鼻孔形状。

结果

Le Fort I 手术后,鼻翼基底宽度、鼻翼宽度和左右鼻孔纵轴之间的角度显著增加(P<0.05)。鼻尖突出明显减少(P=0.022)。多元线性回归分析显示,上颌骨每 1mm 内移量会导致左右鼻孔纵轴之间的角度增加 3.34°(P=0.03,调整 R2=0.21)。根据改良 Topinard 系统的鼻孔类型分类显著改变(P=0.000)。

结论

外科医生应该意识到改良 Topinard 系统边缘病例术后非美学结果的风险。改良 Topinard 分类可能需要从底视图纳入术前正颌计划中。

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