Materials and methods
This single-center, cross-sectional study was conducted at XXX
University, School of Medicine, Department of Plastic, Reconstructive
and Aesthetic Surgery Department between September 2017 and June 2018. A
total of 546 male adolescents aged 15 to 17 years without any known
history of major facial trauma and sport injuries were included in the
study. Those with a history of major nasal trauma, nasal surgery,
congenital and/or acquired cranio-facial and hand anomalies were
excluded. The participants were randomly selected from six high schools
of XXX municipality of XXX province. All participants were informed
about the nature of the study and a written informed consent was
obtained from parents and/or legal guardians of the participants. The
study protocol was approved by the institutional Ethics Committee (No:
09.2016.275; Date: 01/04/2016). The study was conducted in accordance
with the principles of the Declaration of Helsinki.
All examinations were performed by a single plastic surgeon through
inspection. The midline was determined using the midpoint of the nasion
and nasal spine. Accordingly, each participant was examined for the
presence or absence of nasal bone pyramidal deviation, caudal septal
deviation, side of the deviation, and nostril asymmetry. The data were
recorded in the Microsoft Excel table.
The dominant hand was recorded on the personal profile of the
participant for the preferred hand mostly used for activities such as
writing, using forks and knives, throwing objects, grabbing door
handles, and waving.
According to the XXX District Governorship data, there were a total of
34,612 high school students with the overall district population of
712,000 individuals at the time of this study, representing 5% of the
population (14). Using the simple random sampling, minimum 203
participants were required with d=0.03 and p=0.05.
Statistical analysis was performed using the Statistical Package for the
Social Sciences (SPSS) for Windows version 23.0 (IBM Corp., Armonk, NY,
USA). Descriptive data were expressed in mean ± standard deviation (SD),
median (min-max) or number and frequency, where applicable. The
normality was checked using the Shapiro-Wilk test. As the normality was
not achieved, non-parametric Mann-Whitney U test was used for pairwise
comparisons. The Kruskal-Wallis H test was used for multiple
comparisons. A p value of <0.05 was considered statistically
significant.