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1.
J Formos Med Assoc ; 120(9): 1768-1776, 2021 Sep.
Article in English | MEDLINE | ID: mdl-33775535

ABSTRACT

BACKGROUND/PURPOSE: Three-dimensional computer-assisted orthognathic surgery allows to simulate the space between the mandibular ramus segments, i.e. intersegmental gap, for the correction of facial asymmetry. The purposes of the study were to estimate the screws- and mandible bone-related changes from the early postoperative period to the period after the debonding and to measure the association between the intersegmental gap volume and the screws- and mandible bone-related changes. METHODS: This cone-beam computed tomography (CBCT)-assisted retrospective study assessed the stability of the bicortical positional screw fixations in maintaining the space between the mandibular ramus segments after bilateral sagittal split osteotomy in correction of 31 patients with malocclusion and facial asymmetry. The primary predictor variable was the CBCT-based intersegmental gap volume at early postoperative period (T1). The primary outcome variables were CBCT-based screws- and bone-related measurement changes between the T1 and T2 (at debonding) periods. RESULTS: No significant differences were observed in screws-related linear and angular measurements between T1 and T2 virtual models. Some of mandible bone-related linear and angular measurements had significant differences (P < 0.05) between the T1 and T2 images, but with no clinical repercussion such as need of revisionary surgery. The gap volume and the screws- and bone-related changes had no significant correlations. CONCLUSION: This study contributes to the multidisciplinary-related literature by demonstrating that the bicortical positional screws-based fixation technique in maintaining the three-dimensional-simulated space between the mandibular ramus segments is a stable and clinically acceptable option for correction of facial asymmetry associated with malocclusion, regardless of intersegmental gap size.


Subject(s)
Osteotomy, Sagittal Split Ramus , Prognathism , Cephalometry , Humans , Mandible/diagnostic imaging , Mandible/surgery , Retrospective Studies
2.
Plast Reconstr Surg ; 145(5): 1223-1236, 2020 05.
Article in English | MEDLINE | ID: mdl-32332542

ABSTRACT

BACKGROUND: Primary rhinoplasty has not been universally adopted because the potential for nasal growth impairment remains an unsolved issue in cleft care. This study's purpose was to assess the long-term effects of primary rhinoplasty performed by a single surgeon in a cohort of patients with a unilateral cleft lip nose deformity. METHODS: Three-dimensional nasal morphometric measurements (linear, angular, proportional, surface area, and volume) were collected from consecutive patients (cleft group, n = 52; mean age, 19 ± 1 year) who had undergone primary rhinoplasty with the use of the Noordhoff approach between 1995 and 2002 and reached skeletal maturity. Normal age-, sex-, and ethnicity-matched subjects (control group, n = 52) were identified for comparative analyses. RESULTS: No significant differences (all p > 0.05) were observed for most measures, including nasal height, alar width, nasal dorsum angle, columellar angle, columellar-labial angle, nasal tip/height ratio, nasal index, alar width/intercanthal distance ratio, nasal surface area, and nasal volume. The cleft group displayed significantly (all p < 0.05) lower nasal bridge length and nasal tip projection, and greater nasal protrusion, tip/midline deviation, nasal tip angle, nasal tip protrusion width index, and alar width/mouth ratio values than the control group. CONCLUSIONS: Primary rhinoplasty does not interfere with nasal growth as measured by three-dimensional photogrammetric analysis. Further imaging studies are required for the assessment of development in other anatomical nasal structures. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.


Subject(s)
Cleft Lip/surgery , Imaging, Three-Dimensional , Nose/growth & development , Photogrammetry , Rhinoplasty/adverse effects , Adolescent , Case-Control Studies , Female , Follow-Up Studies , Healthy Volunteers , Humans , Male , Nose/abnormalities , Nose/diagnostic imaging , Nose/surgery , Retrospective Studies , Rhinoplasty/methods , Software , Treatment Outcome , Young Adult
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