Surgically assisted maxillary expansion imparts three-dimensional nasal change.
OBJECTIVE
The impact of surgically assisted maxillary expansion (SAME) on facial soft tissue structures has not been adequately studied using 3-dimensional (3D) objective analysis. The purpose of this study was to analyze nasolabial soft tissue after SAME using 3D photographic technology.


METHODS
This was a retrospective cohort study of patients undergoing SAME in which pre- and postexpansion 3D photographs (3D VECTRA Photosystem, Canfield, Fairfield, NJ) were analyzed. Nasolabial anthropometric measurements were performed using the 3D postprocessing software (Mirror). A follow-up period of at least 6 months was required for final evaluation. Two observers verified the landmarks on each dataset before measuring. Statistical analysis involved the paired t test, the Simes correction for multiple comparisons, and repeated measures analysis of covariance (ANCOVA) to control for age, gender, and the time lag between pre- and postoperative assessments.


RESULTS
Twelve patients (24 photogrammetric datasets) were included. The male-to-female ratio was 0.5 (mean age, 17.3 yr). Nasal changes after SAME showed significant increases (P < .05) in alar width (from 33.1 to 34.5 mm), sill width (from 9.2 to 9.7 mm), and columella projection (from 94.1 to 95.1 mm) after the Simes correction. ANCOVA showed a significant increase in alar base width. Distinct changes in nostril shape and dimension were found, but lacked statistical significance.


CONCLUSIONS
Three-dimensional analysis shows widening of the alar width and alar base width after SAME. The magnitude of nasal change parallels that of expansion at the piriform aperture.
Craniofacial Fellow, Department of Plastic and Reconstructive Surgery, Yale University School of Medicine, New Haven, CT.
Philipp
P
Metzler
Student, Department of Plastic and Reconstructive Surgery, Yale University School of Medicine, New Haven, CT.
Erik J
EJ
Geiger
Resident, Department of Plastic and Reconstructive Surgery, Yale University School of Medicine, New Haven, CT.
Christopher C
CC
Chang
Director, Craniofacial Program, Department of Plastic and Reconstructive Surgery, Yale University School of Medicine, New Haven, CT. Electronic address: derek.steinbacher@gmail.com.
Derek M
DM
Steinbacher
D000293:Adolescent; D000328:Adult; D059925:Anatomic Landmarks / Q000033:anatomy & histology; D002508:Cephalometry / Q000379:methods; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D008046:Lip / Q000033:anatomy & histology; D008297:Male; D008437:Maxilla / Q000601:surgery*; D055171:Nasal Cartilages / Q000033:anatomy & histology; D009666:Nose / Q000033:anatomy & histology*; D016382:Orthodontic Appliance Design; D019857:Osteogenesis, Distraction / Q000295:instrumentation; D019340:Osteotomy, Le Fort / Q000379:methods; D010155:Palatal Expansion Technique / Q000295:instrumentation; D010780:Photogrammetry / Q000379:methods; D012189:Retrospective Studies; D055815:Young Adult