Evaluation of facial asymmetry in patients with crooked nose

Today, patients with crocked noses have a special place in rhinoplasty surgery, which is frequently applied for functional and aesthetic purposes. The crocked nose deformity is defined in 3 subgroups: I-type (linear), C-type, and S-type. The symmetrical harmony of the structures on our face forms the basis of the perception of attraction. Therefore, it is important to evaluate the facial asymmetry sensitively in patients with curved nose and to share the results with the patients. Our study aims to evaluate the relationship between facial asymmetry and crocked noses using objective methods. Our study included 57 patients who applied to Hacettepe Ear Nose and Throat Diseases with aesthetic concerns between 2019-2022. After taking photographs in accordance with the procedure in Hacettepe University Faculty of Dentistry Department of Orthodontics and cone beam computed tomography images were taken. These images were arranged with 3D reshaping and 15 different parameters were measured separately for the right and left faces. Of the patients included in our study, 32 (56.1%) were female and 25 (43.9%) were male. Nasal obstruction was present in 50 (87.7%) of the patients, and septum deviation was detected in 46 (80.7%) of them. 21 (36.8%) of our patients had I-type and 15 (26.3%) C-type axis deviations, and 21 (36.8%) patients did not have axis deviations. A significant difference was found in the three-group analysis in the G-LO and Rh-LO parameters used in the evaluation of the upper face region (p=0.002 and p<0.001). Considering the data of the midface region, a statistically significant difference was found between the three groups in all three parameters (G-Zy p=0.04, Rh-Zy p<0.001, ANÇ-Zy p<0.001). There was no significant difference between the three groups in Gn-AM and Ch-Go obtained for the evaluation of the lower face (p=0.056 and p=0.09). In addition, a statistically significant difference was found in soft tissue parameters Go and LO (p=0.008 and p=0.005). There are asymmetries especially on the upper face and middle face in the patients with crooked nose. The glabella on the upper face and the anterior nasal prominence on the mid-face are stable points, and the fact that the parameters derived from these two triangulation points are significant, strongly supports the above statement when considered holistically with the other significant parameters. In addition, the difference in nasal bone lengths in patients with curved noses has been objectively demonstrated.