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Comprehensive analysis of lateral nasal wall anatomy to optimize the osteotomy in different skeletal patterns

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Abstract

Purpose

Variations in nasal wall anatomy are crucial in patients with dentofacial deformities undergoing Le Fort I osteotomy. These structural variations heighten the potential for complications during surgical procedures. Hence, the study focused on evaluating the differences in the lateral nasal wall anatomy across different skeletal Classes.

Methods

This study evaluated 86 patients aged 18–43 years with different skeletal Classes. In the axial images acquired from coronal sections, two angulations and the linear distances of the lateral nasal wall were measured in Class I, II, and III patients. The measurement between the piriform opening and the most anterior point of the greater palatine foramen was evaluated in three parts regarding the osteotomy line. Differences between the skeletal patterns were analyzed using an independent sample t-test and Mann–Whitney U test with a significance level of 0.05. The intra-class correlation coefficient was calculated for inter-observer and intra-observer agreement.

Results

There was a statistically significant difference between Class I and Class II subjects regarding the anterior lateral nasal wall (p = 0.011) and anterior nasal thickness (a) (0.004). There was a significant difference between Class I and Class III patients regarding anterior nasal thickness (a) (p < 0.001) and total lateral nasal wall length (p < 0.001).

Conclusion

For instance, the measurements of Class III and Class II patients were relatively different from those of the Class I patients. Therefore, preoperative Cone-Beam Computed Tomographic analysis should be performed for each patient prior to Le Fort I osteotomy to ensure that the procedure is performed safely.

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Data availability

The data presented in this study are available upon reasonable request to the corresponding author.

References

  1. Apinhasmit W, Chompoopong S, Methathrathip D, Sangvichien S, Karuwanarint S (2015) Clinical anatomy of the posterior maxilla pertaining to Le Fort I osteotomy in Thais. Clin Anat 18(5):323–329. https://doi.org/10.1002/ca.20131

    Article  Google Scholar 

  2. Becker DG, McLaughlin RB Jr, Loevner LA, Mang A (2000) The lateral osteotomy in rhinoplasty: clinical and radiographic rationale for osteotome selection. Plast Reconstr Surg 105(5):1806–1816

    Article  CAS  PubMed  Google Scholar 

  3. Chen X, Zhu J, Guo S, Hu Y, Jiang H (2021) CBCT study on the positional relationship between marginal points of pterygomaxillary junction and anterior nasal spine. Surg Radiol Anat 43(2):219–224. https://doi.org/10.1007/s00276-020-02582-9

    Article  PubMed  Google Scholar 

  4. Ghavimi MA, Nezafati S, Yazdani J, Pourlak T, Amini M, Pourlak T, Ghoreishizadeh A, Negahdari R (2018) Comparison of edema and ecchymosis in rhinoplasty candidates after lateral nasal osteotomy using piezosurgery and external osteotomy. J Adv Pharm Technol Res 9(3):87–93. https://doi.org/10.4103/japtr.JAPTR_294_18

    Article  Google Scholar 

  5. Harshbarger RJ, Sullivan PK (1999) Lateral nasal osteotomies: implications of bony thickness on fracture patterns. Ann Plast Surg 42(4):365–370

    Article  CAS  PubMed  Google Scholar 

  6. Hui L, Hung KF, Bornstein MM, Leung YY (2022) Linear and angular measurement using cone-beam computed tomography to enhance safety in Le Fort I osteotomy with tuberosity cut. Clin Oral Investig 26(12):7095–7105. https://doi.org/10.1007/s00784-022-04669-6

    Article  PubMed  Google Scholar 

  7. Lacerda-Santos JT, Granja GL, de Freitas GB, Manhães LRC Jr, de Melo DP, Dos Santos JA (2022) The influence of facial types on the morphology and location of the greater palatine foramen: a CBCT study. Oral Radiol 38(3):337–343. https://doi.org/10.1007/s11282-021-00563-1

    Article  PubMed  Google Scholar 

  8. Lanigan DT, Hey JH, West RA (1990) Aseptic necrosis following maxillary osteotomies: report of 36 cases. J Oral Maxillofac Surg 48(2):142–156. https://doi.org/10.1016/S0278-2391(10)80202-2

    Article  CAS  PubMed  Google Scholar 

  9. Li KK, Meara JG, Alexander A (1996) Location of the descending palatine artery in relation to the Le Fort I osteotomy. Int J Oral Maxillofac Surg 54:822–825. https://doi.org/10.1016/S0278-2391(96)90528-5

    Article  CAS  Google Scholar 

  10. Nanda R (2005) Biomechanics and esthetic strategies in clinical orthodontics. Elsevier Health Sciences/Saunders, Philadelphia

    Google Scholar 

  11. Odabasi O, Erkmen E, Ucok CO, Bakir MA, Keriş YE, Şahin O (2021) Morphometric analysis of pterygomaxillary region by using cone beam computed tomography. J Stomatol Oral Maxillofac Surg 122(3):273–277. https://doi.org/10.1016/j.jormas.2020.06.006

    Article  CAS  PubMed  Google Scholar 

  12. Oliveira GQV, Rossi MA, Vasconcelos TV, Neves FS, Crusoe-Rebello I (2017) Cone beam computed tomography assessment of the pterygomaxillary region and palatine canal for Le Fort I osteotomy. Int J Oral Maxillofac Surg 46(8):1017–1023. https://doi.org/10.1016/j.ijom.2017.03.030

    Article  CAS  PubMed  Google Scholar 

  13. Panula K, Finne K, Oikarinen K (2001) Incidence of complications and problems related to orthognathic surgery: a review of 655 patients. J Oral Maxillofac Surg 59(10):1128–1136. https://doi.org/10.1053/joms.2001.26704

    Article  CAS  PubMed  Google Scholar 

  14. Park B, Jang WH, Lee BK (2019) An idiopathic delayed maxillary hemorrhage after orthognathic surgery with Le Fort I osteotomy: a case report. J Korean Assoc Oral Maxillofac Surg 45(6):364–368

    Article  PubMed  PubMed Central  Google Scholar 

  15. Ravelo V, Olate G, Muñoz G, de Moraes M, Olate, S (2021) The airway volume related to the maxillo-mandibular position using 3D analysis. Biomed Res Int 2021:6670191, 8 pages.https://doi.org/10.1155/2021/6670191

  16. Suzen M, Temiz M, Demirel O, Uckan S (2021) Surgical protocol for a safe lateral nasal wall osteotomy. J Craniofac Surg 31(3):853–855. https://doi.org/10.1097/SCS.0000000000006179

    Article  Google Scholar 

  17. Suzen M, Temiz M, Cesur K, Uckan S (2023) Safe limits of lateral nasal wall osteotomy at Le Fort I surgery. ORL J Otorhinolaryngol Relat Spec 85(2):97–103. https://doi.org/10.1159/000528512

    Article  PubMed  Google Scholar 

  18. Tunis TS, May H, Sarig R, Vardimon AD, Hershkovitz I, Shpack N (2021) Are chin and symphysis morphology facial type–dependent? A computed tomography-based study. Am J of Orthod Dentofacial Orthop 160(1):84–93. https://doi.org/10.1016/j.ajodo.2020.03.031

    Article  Google Scholar 

  19. Ueki K, Hashiba Y, Marukawa K, Nakagawa K, Okabe K, Yamamoto E (2009) Determining the anatomy of the descending palatine artery and pterygoid plates with computed tomography in Class III patients. J Craniomaxillofac Surg 37(8):469–473. https://doi.org/10.1016/j.jcms.2009.03.010

    Article  PubMed  Google Scholar 

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Funding

No funding was received for conducting this study.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ankara Medipol University, Ankara, Turkey

    Hacer Eberliköse, Arif Yigit Güler, Raha Akbarihamed & Hakan Alpay Karasu

  2. Department of Prosthodontics, Faculty of Dentistry, Ankara Medipol University, Ankara, Turkey

    Caner Öztürk

Authors
  1. Hacer Eberliköse
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  2. Arif Yigit Güler
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  3. Raha Akbarihamed
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  4. Caner Öztürk
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  5. Hakan Alpay Karasu
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Contributions

Protocol/project development: HE, RA, CÖ, HAK. Data collection or management: HE, RA, CÖ, AYG. Data analysis: HE, AYG. Manuscript writing/editing: HE, CÖ, RA.

Corresponding author

Correspondence to Hacer Eberliköse.

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Conflict of interest

The authors declare no conflict of interest.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. This research was approved by the ethics committee of Ankara Medipol University (Protocol No: 64).

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Eberliköse, H., Güler, A.Y., Akbarihamed, R. et al. Comprehensive analysis of lateral nasal wall anatomy to optimize the osteotomy in different skeletal patterns. Surg Radiol Anat 46, 327–332 (2024). https://doi.org/10.1007/s00276-023-03292-8

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  • DOI: https://doi.org/10.1007/s00276-023-03292-8

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