Surgically assisted maxillary expansion imparts three-dimensional nasal change

J Oral Maxillofac Surg. 2014 Oct;72(10):2005-14. doi: 10.1016/j.joms.2014.03.004. Epub 2014 Mar 13.

Abstract

Purpose: 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.

Materials and methods: 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.

Results: 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.

Conclusion: 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.

MeSH terms

  • Adolescent
  • Adult
  • Anatomic Landmarks / anatomy & histology
  • Cephalometry / methods
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Image Processing, Computer-Assisted / methods
  • Imaging, Three-Dimensional / methods
  • Lip / anatomy & histology
  • Male
  • Maxilla / surgery*
  • Nasal Cartilages / anatomy & histology
  • Nose / anatomy & histology*
  • Orthodontic Appliance Design
  • Osteogenesis, Distraction / instrumentation
  • Osteotomy, Le Fort / methods
  • Palatal Expansion Technique* / instrumentation
  • Photogrammetry / methods
  • Retrospective Studies
  • Young Adult