Concomitant treatment of developmental jaw deformities with rhinoplasty

The purpose of this paper is to emphasize the importance of a complete assessment of facial profile and dentition in selected patients who seek rhinoplasty or correction of developmental jaw anomalies. To offer these individuals the optimum result, it is mandatory to have close liaison with an orthodontic colleague. At times it may be necessary for the surgeon to urge orthodontic care even though this was not contemplated by the patient. The orthodontist will prepare occlusion and study models of the teeth. X-ray examination includes a Panorex projection and cephalometric radiography. The surgeon should be familiar with the rudiments of skeletal analysis, as it facilitates joint discussion of the proposed treatment. Soft tissue profile, photographs, and clinical examination complete the assessment. A wafer splint is an important adjunct for accurate placement of the occlusion at the time of surgery. Three patients are presented to illustrate the advantage of combined treatment planning. The end result in each has been enhanced. In maxillary protrusion, simultaneous osteotomy and rhinoplasty have halved the surgical procedures required.