Changes in nasal profile following maxillomandibular osteotomy for prognathism

Abstract

This article is based on a pre- and postoperative retrospective analysis of a sample of patients affected by progenic syndrome who underwent maxillary bone repositioning by maxillomandibular osteotomies. Pre- and postoperative clinical, photographic, and cephalometric analysis are carried out to assess modifications of the nasal shape due to maxillary osteotomies. The sample group studied was made up of 25 patients (13 women, 12 men) who underwent orthodontic-surgical treatment for correction of maxillomandibular deformities. The sample group was divided into two groups: the first (group A) was made up of patients who underwent maxillomandibular repositioning with advancement and lowering of the maxilla, and the second (group B) comprised patients who, as a consequence of surgical repositioning, had a maxilla that was advanced and raised. Surgical treatment was based on Le Fort I and quadrangular Le Fort osteotomies. Evaluation of angular and linear measurements, derived from both photographic and cephalometric material, allowed the authors to compare the two groups of patients and the modifications of the nasal region. These results are then compared with those available from current scientific literature so as to define the predictability of nasal shape modification. In conclusion, it is inadvisable to perform rhinoplasty at the time of orthognathic surgery to correct pre-existing defects, such as a dorsal hump, a nasal base that is too wide or too narrow, a nasal pyramid deviation, or other esthetic defects resulting from orthognathic surgery.