Maxillofacial Abnormalities, Maxillofacial Deformity, Maxillo-facial Surgery
Conditions
Keywords
subspinal osteotomy, edema, nasolabial changes
Brief summary
Following surgical operations, patients have aesthetic expectations as well as functional ones. To minimize undesirable aesthetic results after surgery and to increase the effectiveness of the surgery, the surgical method used for maximum aesthetic results is important, both in pre-operative planning and during surgery. In addition, effective control of bleeding and subsequent edema during surgical operations is a high priority for clinical research in surgical applications. Controlling edema and soft tissue damage improves the quality of life of patients after surgery, reduces morbidity and provides greater comfort, and also allows patients to recover quickly and return to their daily activities sooner. Although the developing edema is temporary, it is known to cause serious depressive disorders in some patients. Minimally invasive approach and maximum aesthetic results during surgery are affected by the surgical technique. This study will contribute to the literature by comparing subspinal Le Fort osteotomy with conventional osteotomy.
Detailed description
In this study, the effect of the type of osteotomy used in the osteotomy phase of orthognathic surgery on the changing parameters (bleeding, edema, soft tissue changes, etc.) during and after surgery will be investigated. While comparing conventional Le Fort I osteotomy with subspinal Le Fort I osteotomy, the advantages and disadvantages of the surgical techniques in the intraoperative and postoperative periods will be determined. This will be the first study to evaluate nasolabial soft tissue changes after subspinal Le Fort osteotomy and to subjectively and objectively compare it with conventional osteotomy performed without v-y closure and cinch sutures, and to evaluate the effect of both methods on postoperative edema. Subspinal Le Fort osteotomy is thought to minimize the widening of the nasal floor. This study has a unique value because it not only evaluates the soft tissue effectiveness of Le Fort osteotomy methods but also provides a three-dimensional comparison of these variables and a subjective explanation. Simultaneously comparing many parameters during and after surgery, and thanks to the results obtained from this study, it will contribute to increasing both the in-operative comfort of oral surgeons and the post-operative comfort of patients. the result of this study, subspinal Le Fort osteotomy will reduce bleeding by reducing dissection during surgery, minimize damage to soft tissues, and prevent unwanted soft tissue changes after surgery.
Interventions
PROCEDUREconventional le fort I osteotomy type
that performed with conventional Le Fort I
PROCEDUREsubspinal le fort I osteotomy type
Osteotomy was performed in the subspinal Le Fort I group that is described by Mommaerts
Sponsors
TC Erciyes University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Masking description
double blind
Intervention model description
double blind
Eligibility
Sex/Gender
ALL
Age
18 Years to 40 Years
Healthy volunteers
Yes
Inclusion criteria
* ASA I, * without systemic disease, * without any drug allergy, * and without a history of NSAID use in the week before the operation, * patients in both groups did not apply alar cinch suture, V-Y closure, or ANS reduction
Exclusion criteria
* history of cleft lip palate and rhinoplasty
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| nasal base width | up to six months | Nasal base width refers to the transverse distance between the most lateral points of the alar bases, reflecting the overall width of the nasal foundation at the level of the nostrils. Measurement: It is measured as the linear distance between the right and left alare (al-al) points on frontal view photographs or 3D images, typically using digital calipers or imaging software. |
| alar base width | up to six months | Alar base width is defined as the horizontal distance between the most lateral insertion points of the alar bases where the nostrils meet the cheek. Measurement: It is measured as the linear distance between the right and left alare (al-al) landmarks on frontal photographs or 3D stereophotogrammetric images, using calibrated digital software or calipers. |
| upper lip length | up to six months | Upper lip length is defined as the vertical distance between the subnasale and the labiale superius, representing the height of the upper lip in the midline. Measurement: It is measured as the linear distance from subnasale (Sn) to labiale superius (Ls) on profile or frontal images using digital measurement software or calipers. |
| nasolabial angle | up to six monts | Nasolabial angle is the angle formed between the columella and the upper lip, reflecting the anteroposterior position and rotation of the nasal tip relative to the upper lip. Measurement: It is measured as the angle between a line drawn from subnasale to columella (columellar tangent) and a line from subnasale to labiale superius on lateral profile images or cephalometric analysis. |
| columellalobular angle | up to six months | Columellalobular angle is the angle formed between the columella and the infratip lobule, reflecting the contour and transition between the nasal tip and columella. Measurement: It is measured as the angle between the columellar line and the infratip lobular line on lateral profile photographs or 3D images using digital analysis software. |
| nasal tip angle | up to six months | Nasal tip angle is defined as the angle formed at the pronasale by the intersection of lines extending from the nasion to the pronasale and from the pronasale to the columella, reflecting nasal tip projection and rotation. Measurement: It is measured on lateral profile images as the angle between the nasion-pronasale line and the pronasale-columella line using digital software or cephalometric analysis tools. |
| nostril width | up to six months | Nostril width is defined as the maximum horizontal distance across an individual nostril, reflecting the transverse dimension of the nostril aperture. Measurement: It is measured as the widest distance between the medial and lateral borders of the nostril on basal view photographs or 3D images using calibrated digital software or calipers. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| edema | up to six months | Also, the images were used to compare postoperative edema between the groups. To determine even the minutest difference between the two groups, three-dimensional (3D) images were taken at preoperatively and postoperatively on 1, 3, 7, 14, 21, 30 day, 3 month and 6 month after surgery at maximum intercuspidation when the lips were free and the eyes were open |
| rhinoplasty outcome evaluation (roe scale) | up to six months | The Rhinoplasty Outcome Evaluation is a patient-reported outcome measure designed to assess satisfaction with nasal appearance and function following rhinoplasty. Measurement: It consists of 6 questions, each scored from 0 (most negative) to 4 (most positive); the total score is summed, divided by the maximum possible score (24), and multiplied by 100 to yield a percentage score ranging from 0 to 100, where higher scores indicate greater patient satisfaction. |
Countries
Turkey (Türkiye)
Outcome results
None listed