Evaluation of craniofacial asymmetry in patients with septal deviations using cone-beam computerized tomography

Aim: Nasal septum is known to play a direct and indirect role in the premaxillary and maxillary growth. Therefore nasal septal deviation may cause of facial asymmetry. The purpose of this study is to evaluate the facial asymmetry by 3D using Cone Beam Computed Tomography (CBCT) in adult subjects with nasal septal deviation. Material and Method: 42 subjects (mean age: 25.18±3.45) constituting the study group with nasal septum deviation and 21 symmetrical facial subjects ( mean age: 24.06±4.45) constituting the control group without septum deviation were included in the study. The cone-beam computed tomography images of all subjects were evaluated by three dimensional (3D) with transferring them to Simplant O&O software program. Anatomical landmarks were identified and all three sections were examined for asymmetry evaluation. Results: When the data were evaluated, the asymmetry on jugular and nasal landmarks in the hard tissue and on the alare and pronasal landmarks in the soft tissue were determined in the study group. The deviations of the mid maxillary plane relative to the midsagittal reference plane are statistically significant. Maxillopalatal arch angle (MPAA) value for the study group was found significantly narrower than the control group. Ratio of palatal arch depth (PAD) / palatal interalveolar length (PIL) was found significantly higher in the study group (0.46 ± 0.06) than the control group (0.42 ± 0.06) (p < 0.05). Conclusions: Facial asymmetry was determined in the middle third of the face in subjects with nasal septal deviation. The palatal region was found to be skeletally affected in patients with nasal septum deviations. However, nasal septal deviation was uncorrelated with the overall magnitude of asymmetry and other measurements. Key Words: Facial asymmetry, Nasal septal deviation, Cone Beam Computed Tomography (CBCT).