CHANGES IN NASAL TIP PROJECTION AND ROTATION AFTER SEPTORHINOPLASTY -A CEPHALOMETRIC ANALYSIS

Purpose: This prospective study reports on changes in nasal tip projec tion and nasal tip rotation before and after septorhinoplasty analyzed cephalometrically. Patients and Methods: Forty patients undergoing pr imary septorhinoplasty were studied prospectively. Lateral cephalometr ic radiographs taken hi the natural head position were obtained before and 6 to 45 months (mean, 17.1) after surgery. In 10 patients, serial radiographs were taken at 6 and 12 months, and in seven patients they were taken at 12 and 24 months after surgery. Nasal tip projection (N TP) was defined as the distance between articulare (Ar) and pronasion (PRN). Nasal lip rotation (NTR) was defined as the change in the angle (N-Ar-PRN) after surgery. A surgical goal to increase, decrease, or m aintain NTP and NTR was assigned to each patient before surgery. Resul ts: NTP changed in the desired direction in 16 of 40 patients (40%). N TR changed in the desired direction in 25 of 40 patients (63%). In the patients studied serially, NTP decreased an average 0.7 mm between 6 and 12 months (P = .018), and 0.6 mm between 12 and 24 months (P = .07 1). Conclusions: Decreased NTP and NTR were the most easily achieved s urgical objectives. Maintaining or increasing NTP is less predictable. Typically, there is a progressive loss of NTP after surgery independe nt of the surgical goal. Cephalometric analysis is a useful tool to me asure changes in NTP and NTR after septorhinoplasty.