上顎前方移動術後に認められる外鼻の形態変化について

抄録

Morphological changes in the external nose after surgical anterior shift of the maxilla were evaluated. The absence of morphological change is desirable unless morphological modification is an objective of the surgery. Presently, however, the degree of postoperative morphological changes in the external nose is difficult to anticipate. Morphological changes are clinically encountered also during the period of postoperative orthodontic treatment. In this study,primarily postoperative morphological changes in the external nose and the course of such changes were evaluated. We examined 9 females who underwent surgical anterior shift of the maxilla at our university hospital school of dentistry, using standard lateral head X-ray films and front-view facial photographs in the natural position obtained before,1 month after, and 1 year after surgery. The apex of the nose was shifted anteriorly in all patients

<br>1 month after surgery but returned posteriorly in 8 of the 9 patients after 1 year. Vertically, upward shifts of the nasal apex were observed in 7 of the 9 patients, and downward shifts were observed in the remaining 2.Returns to the preoperative level were observed in 7 of the 9 patients including those that showed downward shifts. The distance between the wings of the nose was increased in all patients 1 month after surgery. It showed a return in 4 of them after 1 year but increased further in the remaining 5. The acceptable range of morphological changes of the external nose varies among individuals and is difficult to evaluate using a uniform scale, but none of the 9 patients in this study complained about the postoperative nasal morphology. However, morphological changes did occur, and further improvernents in preventive measures against them are anticipated. Also, considerations of the external nose morphology are thought to be necessary in planning occlusal reconstitution.