Overview: In the modern world it is becoming more actual surgical treatment of patients with dentofacial anomalies, consisting in carrying out one-stage orthognathic surgery and rhinoseptoplasty. In this case, preoperative planning of the future nose shape has a number of features and complexity.
Objective: To identify the features and estimate the predictability of the preoperative planning of the nose shape in case of one-stage surgery.
Materials and methods: There were 21 patients (women 16–45) with different classes of malocclusion, who underwent one-stage orthognathic surgery and rhinoseptoplasty. Orthognathic protocol was consisted of the Le Fort I osteotomy, BSSO and genioplasty in case of necessity and rhinoseptoplasty was made by ‘close’ surgery protocol. Computer simulation of the future nose shape was made. Pre-surgical, on stage of planning, intra-surgical (after orthognathic and before rhinoseptoplasty) and post-surgical photos were made. All data regarding nose shape were correlated and analyzed.
Results: In all 21 patients intraoperative nose deformation was marked. Improvement of the nose shape was found in 2 patient, and was required a small correction. In 7 patients there were significant change of the nose shape that was connected with severe malocclusion and facial asymmetry. A slight changes of the nose shape were marked in 12 patients. Changes of the nose shape were as type of worsening of an existing deformation or the change of one deformation type to another. After the orthognathic surgery in 3 patients the nose shape was changed from the ‘hump’ to ‘saddle’ type due to significant shift of nasal septum. In 18 patients changes varied within the range of available deformation.
Conclusions: Changes of the nasal structures after orthognathic surgery have a varying severity. Therefore, the pre-surgical planning of the nose shape in patients with malocclusion is a complex task.
Key words: rhinoplasty; rhinoseptoplasty; nose surgery; orthognathic surgery; surgical planning