title: Nasal changes after orthognathic surgery for patients with prognathism and Class III malocclusion: analysis using three-dimensional photogrammetry.
abstract: OBJECTIVE
  Orthognathic surgery alters the position of maxilla and mandible, and consequently changes the nasal shape. The nasal change remains a concern to Asian patients. The aim of this study was to measure the nasal changes using a novel three-dimensional photographic imaging method.
  
  
  METHODS
  A total of 38 patients with Class III malocclusion and prognathism were enrolled. All patients underwent two-jaw surgery with the standard technique. A nasal alar cinching suture was included at the end of procedure. Facial landmarks and nasal morphology were defined and measured from pre- and postoperative three-dimensional photographic images. Intra-rater errors on landmark identification were controlled. Patient's reports of perceptual nasal changes were recorded.
  
  
  RESULTS
  The average width of the alar base and subalare remained similar after surgery. Alar width was increased by 0.74 mm. Nasal height and length remained the same. Nasolabial angle increased significantly. The area of nostril show revealed a significant increase and was correlated with a decrease of columella inclination. Nasal tip projection decreased significantly, by 1.99 mm. Preoperative nasal morphology was different between patients with and without cleft lip/palate, but most nasal changes were concordant. In the self-perception, 37% of patients reported improved nasal appearance, 58% reported no change, and 5% were not satisfied with the nasal changes.
  
  
  CONCLUSIONS
  After the surgery, characteristic nasal changes occurred with an increase of nasolabial angle and nostril show, but a preserved nasal width. The majority of patients did not perceive adverse nasal changes.
authors.affiliation: Craniofacial Center, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Saran
authors.initials: S
authors.lastname: Worasakwutiphong
authors.affiliation: Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Ya-Fang
authors.initials: YF
authors.lastname: Chuang
authors.affiliation: Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Hsin-Wen
authors.initials: HW
authors.lastname: Chang
authors.affiliation: Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Hsiu-Hsia
authors.initials: HH
authors.lastname: Lin
authors.affiliation: Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Pei-Ju
authors.initials: PJ
authors.lastname: Lin
authors.affiliation: Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan; Department of Plastic and Reconstructive Surgery, Craniofacial Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan. Electronic address: lunjoulo@cgmh.org.tw.
authors.forename: Lun-Jou
authors.initials: LJ
authors.lastname: Lo
mesh_terms: D000293:Adolescent; D000328:Adult; D001828:Body Image; D002972:Cleft Palate; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008313:Malocclusion, Angle Class III / Q000601:surgery*; D008334:Mandible / Q000002:abnormalities; D008437:Maxilla / Q000002:abnormalities; D009666:Nose / Q000002:abnormalities*; D056948:Orthognathic Surgical Procedures / Q000009:adverse effects*; D010780:Photogrammetry / Q000379:methods*; D011183:Postoperative Complications / Q000175:diagnosis*; D011378:Prognathism / Q000601:surgery*; D012189:Retrospective Studies; D013624:Taiwan; D055815:Young Adult
keywords: nasal changes; orthognathic surgery; prognathism; three-dimensional photogrammetry