• Archives of Plastic Surgery
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• v.44 no.5
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• pp.400-406
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• 2017

Background The purpose of this study was to evaluate changes in nasal growth after the implementation of a preoperative nasal retainer in patients with bilateral incomplete cleft lip. Methods Twenty-six infants with bilateral incomplete cleft lip and cleft palate were included in the study. A preoperative nasal retainer was applied in 5 patients from the time of birth to 2.6-3.5 months before primary cheiloplasty. Twenty-one patients who were treated without a preoperative nasal retainer were placed in the control group. Standard frontal, basal, and lateral view photographs were taken 3 weeks before cheiloplasty, immediately after cheiloplasty, and at the 1- and 3-year postoperative follow-up visits. The columella and nasal growth ratio and nasolabial angle were indirectly measured using photographic anthropometry. Results The ratio of columella length to nasal tip protrusion significantly increased after the implementation of a preoperative nasal retainer compared to the control group for up to 3 years postoperatively (P<0.01 for all time points). The ratios of nasal width to facial width, nasal width to intercanthal distance, columellar width to nasal width, and the nasolabial angle, for the two groups were not significantly different at any time point. Conclusions Implementation of a preoperative nasal retainer provided significant advantages for achieving columellar elongation for up to 3 years postoperatively. It is a simple, reasonable option for correcting nostril shape, preventing deformities, and guiding development of facial structures.

• The korean journal of orthodontics
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• v.21 no.3
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• pp.657-670
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• 1991

It was said that early rapid palatal expansion was the treatment of choice in case of maxillary constriction with posterior crossbite. The author tried to assess dimensional changes of nasal and oral cavity before rapid palatal expansion and over 4 months of retention by use of three coronal tomograms through the incisal, molar, and maxillary tuberosity areas. The subjects of this study were consisted of 9 boys and 11 girls ranging from 11 to 13 years old. The results were as follows: 1. A mean change in maxillary first molar width was 3.68mm and a mean change in nasal cavity width was 2.26mm after 6.70mm expansion by Hyrax-type screw and over 4 months of retention tomographically in molar cut. 2. A change in nasal cavity width tomographically showed in order of molar cut, incisal cut, maxillary tuberosity cut respectively. 3. There was no correlation between changes in oral cavity width and nasal cavity width.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.2
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• pp.217-223
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• 1996

In order to evaluate the changes before and after secondary operations in the patients with cleft lip objectively using full face photographs, the author analyzed results of improvement on nasal width and mouth width and asymmetry of nostril. 1. The ration of asymmetry of thenostril is changed from average 1.24 preoperatively to average 1.08 postoperaively : 61.2% is improved postoperatively. 2. The ratio of nasal width compared with intermedial canthal distance is changed from average 1.15 preoperatively to average 1.10 postoperatively : 3.8% is reduced posteroperatively. 3. The ratio of mouth width compared with intermedial canthal distance is changed from average 1.08 preoperatively to average 1.03 postoperathvely : 4.1% is reduced posteroperatively.

• Archives of Craniofacial Surgery
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• v.10 no.2
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• pp.61-66
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• 2009

Purpose: The aim of this study is to establish anatomical dimension of the nose and nostril shape in Korean twenties. Methods: Authors measured anthropometry of nose in Korean youths 1,000 individuals (male 363, female 637) and analyzed stastically them. Results: The mean measurements are as follows. 1. The shape of nostrils was classified into 7 types by the angle between both long axis of nostril (male / female). Type I ($<40^{\circ}$)1.7% / 1.72%, Type II ($41-70^{\circ}$) 26.17% / 29.35%, Type III ($71-100^{\circ}$) 39.94% / 38.77%, Type IV (unclassified) 3.85% / 5.80%, Type V ($101-130^{\circ}$) 20.93% / 17.89%, Type VI ($131-180^{\circ}$) 7.43% / 5.96%, Type VII ($>180^{\circ}$) 0% / 0.47% 2. Lengths (male/female) Width of nasal root: $25.29{\pm}2.25mm/24.72{\pm}2.40mm$ Width of nose: $37.63{\pm}2.46mm/34.77{\pm}2.11mm$ Width of columella: $7.18{\pm}0.92mm/6.92{\pm}0.86mm$ Width of alar: $4.99{\pm}1.00mm/4.74{\pm}0.91mm$ Width of nostril floor: $10.98{\pm}1.40mm/10.13{\pm}1.73mm$ Protrusion of nasal tip: $17.12{\pm}1.95mm/16.88{\pm}1.84mm$ Length of alar: $27.10{\pm}2.21mm/24.66{\pm}2.18mm$ Length of nasal root: $17.37{\pm}2.51mm/16.08{\pm}2.90mm$ Depth of nasal root: $7.83{\pm}1.63mm/6.82{\pm}1.36mm$ Length of columella: $8.13{\pm}1.40mm/7.30{\pm}1.46mm$ Height of nose: $60.50{\pm}8.90mm/59.14{\pm}9.22mm$ Height of nasal bridge: $52.68{\pm}7.49mm/50.57{\pm}7.71mm$ 3. Angles Nasofacial angle: $30.19{\pm}3.43^{\circ}/29.13{\pm}6.31^{\circ}$ Nasofrontal angle: $134.88{\pm}7.25^{\circ}/139.94{\pm}6.33^{\circ}$ Nasolabial angle: $95.08{\pm}8.95^{\circ}/95.80{\pm}8.93^{\circ}$ 4. Nasal index: $72.60{\pm}9.57%/68.21{\pm}7.03%$ Nasal tip protrusion-nasal height index: $45.64{\pm}5.21%/47.09{\pm}5.21%$ Nasal tip protrusion-nasal width index: $32.61{\pm}6.83%/31.63{\pm}6.71%$ Conclusion: These data could be useful reference for anthropometry of nose in Korean twenties.

• The korean journal of orthodontics
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• v.50 no.4
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• pp.249-257
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• 2020

Objective: To evaluate the changes in the nose in three dimensions after Le Fort I osteotomy in patients with skeletal Class III malocclusion. Methods: The subjects were 40 adult patients (20 females and 20 males; mean age, 20.3 ± 3.0 years; range, 17.0 to 31.1 years) who underwent one-piece Le Fort I osteotomy with maxillary advancement and impaction treatment for maxillary hypoplasia. The mean maxillary advancement was 4.56 ± 1.34 mm, and the mean maxillary impaction was 2.03 ± 1.04 mm. Stereophotogrammetry was used to acquire three-dimensional images before and at least 6 months after surgery. Results: Alare (Al) and alare curvature (Ac) points had moved vertically and anterolaterally postoperatively. A significant increase was observed in the nasal ala width and alar base width, and no changes were noted in the columellar length, nasolabial angle, and nasal area. There was a significant relationship between maxillary impaction and nasal ala width and horizontal and sagittal positions of the bilateral Al and Ac. The only relationship found was between maxillary advancement and postoperative sagittal location of the subnasale and pronasale. Conclusions: Nasal soft tissues were highly affected by the vertical movement of the maxilla; however, the soft tissue responses were individual-dependent.

• Imaging Science in Dentistry
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• v.36 no.3
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• pp.145-149
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• 2006

Purpose : To assess the width of the labial alveolar bone of the incisive canal and the width of the incisive canal on spiral computed tomographic images of the anterior portion of the maxilla. Materials and Methods : Study materials included 38 CT scans taken for preoperative planning of implant placement. Axial cross-sectioned image entirely showing the incisive canal was selected and scanned with 600 DPI resolution. The width of the labial alveolar bone of the incisive canal at an orifice to the oral cavity, middle portion, and an orifice to the nasal cavity and the diameter of the incisive canal at the middle portion were determined by two specialist using Digora for Windows 2.1 The statistical analyses were carried out using SPSS 12.0.1. Results : When the maxillary central incisors remained, the mean labial alveolar bone width were $6.81{\pm}1.41mm,\;6.46{\pm}1.33mm$, and $7.91{\pm}1.33mm$. When the maxillary central incisors were missed the mean width were $5.42{\pm}2.20mm,\;6.23{\pm}2.29mm$, and $7.89{\pm}2.13mm$. Conclusions : The labial alveolar bone width at middle portion and an orifice to the nasal cavity were of no statistical significant difference according to presence of the maxillary central incisors (P>0.05). The width between oral cavity and nasal cavity, middle portion and to nasal cavity revealed statistically significant difference (P<0.05).

• The korean journal of orthodontics
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• v.50 no.5
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• pp.314-323
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• 2020

Objective: To identify the available evidence on the effects of rapid maxillary expansion (RME) with three-dimensional imaging and provide meta-analytic data from studies assessing the outcomes using computed tomography. Methods: Eleven electronic databases were searched, and prospective case series were selected. Two authors screened all titles and abstracts and assessed full texts of the remaining articles. Seventeen case series were included in the quantitative synthesis. Seven outcomes were investigated: nasal cavity width, maxillary basal bone width, alveolar buccal crest width, alveolar palatal crest width, inter-molar crown width, inter-molar root apex width, and buccopalatal molar inclination. The outcomes were investigated at two-time points: post-expansion (2-6 weeks) and post-retention (4-8 months). Mean differences and 95% confidence intervals were used to summarize and combine the data. Results: All the investigated outcomes showed significant differences post-expansion (maxillary basal bone width, +2.46 mm; nasal cavity width, +1.95 mm; alveolar buccal crest width, +3.90 mm; alveolar palatal crest width, +3.09 mm; intermolar crown width, +5.69 mm; inter-molar root apex width, +2.85 mm; and dental tipping, +3.75°) and post-retention (maxillary basal bone width, +2.21 mm; nasal cavity width, +1.55 mm; alveolar buccal crest width, +3.57 mm; alveolar palatal crest width, +3.32 mm; inter-molar crown width, +5.43 mm; inter-molar root apex width, +4.75 mm; and dental tipping, 2.22°) compared to pre-expansion. Conclusions: After RME, skeletal expansion of the nasomaxillary complex was greater in most caudal structures. Maxillary basal bone showed 10% post-retention relapse. During retention period, uprighting of maxillary molars occurred.

• The korean journal of orthodontics
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• v.50 no.2
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• pp.75-85
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• 2020

Objective: The aim of this study was to evaluate changes in the nasal soft tissues, including movements of landmarks, changes in linear distances, and volumetric changes, using three-dimensional (3D) stereophotogrammetry after microimplant-assisted rapid palatal expansion (MARPE) in adult patients. Methods: Facial data were scanned using a white light scanner before and after MARPE in 30 patients. In total, 7 mm of expansion was achieved over a 4-week expansion period. We determined 10 soft tissue landmarks using reverse engineering software and measured 3D vector changes at those points. In addition, we calculated the distances between points to determine changes in the width of the nasal soft tissues. The volumetric change in the nose was also measured. Results: All landmarks except pronasale and subnasale showed statistically significant movement on the x-axis. Pronasale, subnasale, alar right, and alar left showed significant movement on the y-axis, while all landmarks except subnasale showed significant movement on the z-axis. The alar base width, alar width, and alar curvature width increased by 1.214, 0.932, and 0.987 mm, respectively. The average volumetric change was 993.33 ㎣, and the amount of increase relative to the average initial volume was 2.96%. Conclusions: The majority of soft tissue landmarks around the nasal region show significant positional changes after MARPE in adults. The nose tends to widen and move forward and downward. The post-treatment nasal volume may also exhibit a significant increase relative to the initial volume. Clinicians should thoroughly explain the anticipated changes to patients before MARPE initiation.

• Archives of Craniofacial Surgery
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• v.25 no.3
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• pp.123-132
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• 2024

Background: The introduction of presurgical nasoalveolar molding represented a significant departure from traditional molding methods. Developed by Grayson and colleagues in 1993, this technique combines an intraoral molding device with a nasal molding stent. This study aimed to compare the Grayson nasoalveolar molding appliance versus DynaCleft appliance as two methods of presurgical nasoalveolar molding. Methods: A single-blinded, randomized, parallel-arm clinical trial was conducted. Sixteen infants with complete unilateral cleft lip and palate were enrolled and divided into two groups of eight. Group 1 was treated with a modified Grayson nasoalveolar molding appliance that included a nasal stent, while group 2 was treated with DynaCleft elastic adhesive tape and an external nasal elevator. Standardized digital photographs of each infant were taken at baseline and post-treatment using a professional camera. Nine extraoral anthropometric measurements were obtained from each image using image measurement software. Results: The modified Grayson nasoalveolar appliance demonstrated a more significant improvement compared to DynaCleft in terms of alar length projection (on both sides), columella angle, and nasal tip projection. Symmetry ratios also showed enhancement, with significant improvements observed in nasal width, nasal basal width, and alar length projection (p< 0.05). Conclusion: Both the modified Grayson nasoalveolar appliance and DynaCleft appear to be effective presurgical infant orthopedics treatment options, demonstrating improvements in nasolabial aesthetics. The modified Grayson appliance, equipped with a nasal stent, improved nasal symmetry more effectively than DynaCleft, resulting in a straighter columella and a more medially positioned nasal tip.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.5
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• pp.406-415
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• 2010

Purpose: The secondary correction of cleft lip nasal deformity still presents a difficult surgical problems. The present study was aimed to investigate the usefulness of Bardach's technique for secondary correction of cleft lip nasal deformity. Materials and Methods: The subjects were eight patients with unilateral and bilateral cleft lip nasal deformity, who had secondary correction by using Bardach's rhinoplasty technique. Age range was from 2 to 21 years and mean age was 10.6 years. There were 3 boys and 5 girls. Six patients had bilateral and two patients had unilateral cleft lip. Facial photographs were taken before and twenty days after the operation. By using Adobe photoshop, the columella height and the nostril width were measured from the facial frontal photograph and Worm's eye view. The degree of improvement was calculated and statistically analyzed. Results: The degree of improvement of the columella length and the nostril width after Bardach's technique was $70.39{\pm}50.14%$ and $-22.93{\pm}0.15%$ respectively. Bardach's technique resulted in projecting the nasal tip, lengthening the columella, medially advancing the alar bases, restructuring the lower lateral cartilages, and changing orientation of the nostrils from horizontal to oblique. The profile view shows projection of the nasal tip, lengthening of the columella, and the change in the nasolabial angle. The scars remained at the philtrum were matter little in compared with improvement of the nasal appearance. Conclusion: These results indicate that Bardach's technique is an useful surgical technique for secondary correction of cleft lip nasal deformity.