Simultaneous maxillary and nasal reconstruction. An analysis of twenty-five cases

This study measures the changes in nasal morphology which accompany simultaneous rhinoplastic and orthognathic reconstruction. The sample includes 25 patients treated over a four-year period, using either facial degloving access or more limited nasal skeletonization in combination with oral incisions. Midfacial and maxillary procedures were performed, as were mandibular osteotomies, intercurrent to both nasal reduction and augmentation. Radiographic, photographic, and clinical assessment selected for skeletal stability and nasal airflow, followed by nasal dorsum, nasal tip, alar and columellar bases, and labial modifications. The relationships of skeletal to soft tissue movements thus obtained are discussed by way of establishing norms, comparing the two approaches, and integrating recent innovations of both rhinoplastic and orthognathic surgery to this abbreviated mode of anatomic and functional reconstruction.