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Orthognathic Surgery and Rhinoplasty: Simultaneous or Staged?
Alexander H Sun1,2, Derek M Steinbacher1,2
1New Haven, Conn.
Plastic and Reconstructive Surgery
|January 26, 2018
Summary
Orthognathic surgery often requires rhinoplasty due to nasal changes. This study proposes an algorithm to guide the timing and necessity of rhinoplasty in orthognathic patients, ensuring optimal aesthetic and functional outcomes.
Area of Science:
- Plastic Surgery
- Oral and Maxillofacial Surgery
- Rhinology
Background:
- Orthognathic surgery can alter the nasolabial envelope, sometimes necessitating a secondary rhinoplasty.
- Understanding nasal morphology changes is crucial for planning orthognathic procedures.
- Predictive variables for adjunctive rhinoplasty need identification.
Purpose of the Study:
- To evaluate nasal morphology in orthognathic surgery patients.
- To identify predictive variables for the need and timing of definitive rhinoplasty.
- To propose an algorithm for implementing adjunctive rhinoplasty.
Main Methods:
- Retrospective review of 163 orthognathic surgery cases over 3 years.
- Analysis of demographic, diagnostic, and operative details.
- Quantification of anatomical variables using 3D imaging.
Main Results:
- 41.7% of orthognathic cases required adjunctive rhinoplasty.
- Staged rhinoplasty (82.4%) was more common than simultaneous (17.6%).
- Significant maxillary movement was more prevalent in staged cases (92.9%) than simultaneous (16.7%).
Conclusions:
- Nasal and jaw deformities are interconnected, influencing treatment planning.
- An algorithm is presented to manage the nasomaxillofacial relationship.
- Orthognathic surgery alone, combined, or staged with rhinoplasty offers comprehensive treatment.
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