Do Gender and Age Influence Nasal Soft Tissue Widening After Bone-Borne Transpalatal Distraction?

Abstract

Widening of the nasal soft tissue after transpalatal distraction (TPD) is a well-known consequence of this treatment method used to correct transverse maxillary deficiency. However, because literature is scarce about the influence of gender and age, the purpose of this study is to estimate changes in the nasal soft tissue after TPD and to measure the association of gender and age with these observed changes. In this retrospective cohort study, patients with transverse maxillary deficiency underwent combined orthodontic-surgical treatment. Maxillary and nasal anatomical landmarks were compared using superimposed cone beam computed tomography images preoperatively and approximately 1year postoperatively. Measurements included nasal soft tissue, nasal skeletal, and maxillary parameters. Significant differences in nasal soft tissue changes were correlated with patient gender, age, maxillary, and nasal skeletal changes using regression models. Ninety one patients were included of which 33 were men (36%) and 58 women (64%). Independent of the maxillary widening, the mean nasal soft tissue widening was limited to 2mm. Nasal soft tissue expansion was 60% to 80% of the nasal skeletal width and 25% to 31% of the skeletal maxillary width. The alar nasal base increased approximately 57% more than the alar nasal width. Significant gender-related differences in nasal soft tissue widening were observed. Age-related differences were identified only as a trend. Small age-related and gender-related differences may not be relevant clinically since there are no established threshold values to assess a layperson's perception of nasal width variations. Technical and/or aesthetic concerns regarding TPD surgery can be addressed without patient's gender and/or age consideration.