Nasal Profile Changes Following Anterior Maxillary Segmental Osteotomy: A Lateral Cephalometric Study

Abstract

Purpose Orthognathic surgery in reference to the maxilla attempts to correct underlying skeletal deformities and improve function. Consequently it has the potential to significantly alter the central esthetic unit of the face, the nasolabial region. In order to evaluate the nasal morphological changes which would result following anterior maxillary segmental osteotomy (superior and posterior repositioning); four angles namely, nasolabial, nasal tip projection, columellar labial and supra tip break angle were evaluated. Method and materials In ten selected subjects who have undergone anterior maxillary segmental osteotomy with superior and posterior repositioning, pre (T1) and post operative (T2) lateral cephalometric parameters pertaining to the four angles were analysed using Wilcoxon signed rank test.Results A significant increase in nasolabial angle and mild changes in nasal tip projection, columellar labial angle and supra tip break angle were observed. Conclusion The results of this study emphasize the need for the pre surgical evaluation of nasal morphology in every individual planned for anterior maxillary segmental osteotomy.

Comparison of Effects Between Total Maxillary Setback Osteotomy and Anterior Maxillary Segmental Osteotomy on Nasolabial Morphology

“…Plastic and Reconstructive Surgery • December 2023 1084e function. However, three-dimensional movement of the maxilla is accompanied by changes in the soft tissues of the nasolabial region, 4,[15][16][17][18][19][23][24][25][26][27][28][29][30][31][32][33][34][35] raising concerns for surgeons. Le Fort I osteotomy, a versatile total maxilla repositioning technique that corrects maxillary deformities, is often used in orthognathic surgery.…”

“…3 Maxillary manipulation for skeletal malocclusion is an effective way to optimize aesthetics and function. However, three-dimensional movement of the maxilla is accompanied by changes in the soft tissues of the nasolabial region, 4,15–19,23–35 raising concerns for surgeons.…”

“…[4][5][6][7][8][9][10][11][12][13][14][15] Nevertheless, a few studies on AMSO suggest that nasolabial angle increases, nasal width slightly widens, and lip length increases. 9,[16][17][18][19] Although the results from both techniques appear similar, these studies are mostly case reports or descriptions of clinical experience, and there are no controlled studies, making the assessments of outcomes less persuasive. In addition, literature Volume 152, Number 6 • Effects of Surgery on Nasolabial Morphology 1077e has reported that orthognathic surgery using Le Fort I osteotomy induced significant changes in the nasal-sinus airway volume.…”

Cephalometric evaluation of soft tissue changes following Anterior Maxillary Osteotomy setback in Southern Dravidian population

“…The most commonly seen effect in maxillary setback procedures is increase in the nasolabial angle. 16 , 18 , 19 …”