Correlation between cephalometric nasal changes and patients' perception after orthognathic surgery

The purpose of this study was to evaluate the correlation between cephalometric measurements and patients' perception of nasal changes in those with Class III malocclusion who had undergone orthognathic surgery.

Eighty-five patients (36 men and 49 women) who received maxillary advancement with (group 1) or without (group 2) maxillary impaction were included in this study. Lateral cephalometric radiographs taken before and at the end of the treatment were analyzed. The patients were given an esthetic evaluation form and asked to evaluate their own noses on the Likert scale (subjective perception), while at the same time, they were asked to evaluate profile silhouettes without knowing that it was their own profile (objective perception). The changes and correlations between the cephalometric measurements and the scores obtained from the esthetic perception questionnaire were evaluated statistically.

Postoperative nasal tip inclination and rotation, nasofacial angle, and sagittal position of pronasale had increased significantly (P <0.05), whereas nasal tip protrusion, nasofrontal angle, and vertical position of pronasale had decreased (P <0.05). The change in the nasolabial angle and vertical position of pronasale was statistically different between the 2 surgical groups (P <0.05). In the end, a significant increase was observed in the patients' objective nasal esthetic scores (P <0.05).

Soft tissues are affected by the vertical and sagittal surgical movements of the maxilla. There was a moderate correlation between patients' perception of nasal changes and cephalometric measurements. The subjective evaluation of the nose was similar among patients after surgery, but in the objective assessment, patients found their noses more esthetic.