目的:本研究旨在确定鼻腔变化与前移量之间的关系,撞击,LeFortI截骨后上颌骨向下运动。
方法:该研究纳入了48例接受LeFortI手术的患者,并有术前和术后锥形束计算机断层扫描记录。通过测量鼻中隔偏角和体积来评估鼻中隔的变化。此外,检查鼻唇沟角度和鼻翼基部宽度。根据A点(上颌牙槽突曲率的最深点)的运动确定组,垂直运动的阈值为1.5毫米,矢状运动的阈值为4毫米。这导致了6组每组8人的比较。结果表示为平均值和标准偏差或中值和范围,取决于数据分布。显著性水平为P<0.05。
结果:术前/术后每个组的间隔偏离体积或角度值没有显着差异。第3组和第5组,都有至少1.5毫米的撞击,在术前和术后测量之间显示出偏差角度和体积的显着变化。鼻唇沟角度在组间无明显变化。第1组的Alar基底宽度和鼻宽度增加显着最高,其矢状运动超过4mm,垂直运动小于1.5mm。
结论:LeFortI截骨术可能导致鼻中隔空间定位发生不良变化。这项研究的结果表明,上颌前移不会显着影响间隔偏离,而上颌嵌塞增加了偏差量。此外,鼻部宽度和鼻翼基部宽度趋于增加,鼻唇沟角度略有减小,无论正颌手术后上颌骨的运动方向如何。
结论:外科医生在计划上颌骨嵌塞时,应考虑鼻中隔偏曲风险增加。鼻子中的软组织变化根据LeFortI手术的不同方向和数量而变化。
OBJECTIVE: This study aimed to determine the relationship between nasal changes and the amount of advancement, impaction, and downward movement of the maxilla after Le Fort I osteotomy.
METHODS: The study included 48 patients who underwent Le Fort I surgery and had pre- and postoperative cone-beam computed tomography records. Changes in the nasal septum were evaluated by measuring septal deviation angles and volumes. In addition, nasolabial angle and width of nasal and alar base were examined. Groups were determined according to the movement of point A (the deepest point on the curvature of the maxillary alveolar process), using a threshold of 1.5 mm for vertical movements and 4 mm for sagittal movements. This resulted in the comparison of 6 groups of 8 people each. Results are presented as mean and standard deviation or median and range depending on the data distribution. Significance level was accepted as P < 0.05.
RESULTS: There were no significant differences for each group on its own septal deviation volume or angle values pre/postoperatively. Groups 3 and 5, which both had at least 1.5 mm of impaction, showed significant changes in both deviation angle and volume between the preoperative and postoperative measurements. Nasolabial angle did not show significant changes between groups. Alar base width and nasal width increase was significantly highest in Group 1, which has more than 4 mm sagittal movement and less than 1.5 mm vertical movement.
CONCLUSIONS: Le Fort I osteotomy may lead to undesirable changes in the spatial positioning of the nasal septum. The results of this study suggest that maxillary advancement does not significantly impact septal deviation, whereas maxillary impaction increases the amount of deviation. In addition, nasal width and alar base width tended to increase, and the nasolabial angle tended to decrease slightly, regardless of the direction of movement of the maxilla after orthognathic surgery.
CONCLUSIONS: Surgeons should consider increased nasal septal deviation risks when planning impaction of the maxilla. The soft tissue changes in the nose vary according to different directions and amounts of Le Fort I surgery.