Three-dimensional virtual simulation of alar width changes following bimaxillary osteotomies.
The aim of this study was to evaluate the accuracy of three-dimensional (3D) soft tissue simulation of nose width changes following bimaxillary osteotomies and to identify patient- and surgery-related factors that may affect the accuracy of simulation. Sixty patients (mean age 26 years) who underwent bimaxillary osteotomies participated in this study. Cone beam computed tomography scans were acquired preoperatively and at 1-year postoperative. The 3D hard and soft tissue rendered preoperative and postoperative virtual head models were superimposed, after which the maxilla and mandible were segmented and aligned to the postoperative position. The postoperative changes in alar width were simulated using a mass tensor model (MTM)-based algorithm and compared with the postoperative outcome. 3D cephalometric analyses were used to quantify the simulation error. The postoperative alar width was increased by 1.6±1.1mm and the mean error between the 3D simulation and the actual postoperative alar width was 1.0±0.9mm. The predictability was not correlated to factors such as age, sex, alar cinch suture, VY closure, maxillary advancement, or a history of surgically assisted rapid maxillary expansion. The MTM-based simulation model of postoperative alar width change was found to be reasonably accurate, although there is room for further improvement.
Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands.
J
J
Liebregts
Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands. Electronic address: Tong.Xi@radboudumc.nl.
T
T
Xi
Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands.
R
R
Schreurs
Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands.
B
B
van Loon
Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands.
S
S
Bergé
Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands.
T
T
Maal
D000293:Adolescent; D000328:Adult; D002508:Cephalometry; D054893:Cone-Beam Computed Tomography; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008875:Middle Aged; D009667:Nose Deformities, Acquired / Q000000981:diagnostic imaging / Q000209:etiology*; D010027:Osteotomy / Q000009:adverse effects*
3D simulation; CBCT; alar cinch; alar width; bimaxillary surgery; nose width