Introduction: The role of nasal septum in development of the maxilla after birth remains to be a question. Study of monozygotic twins may elucidate the role of epigenetic factors in growth and development of craniofacial structures.
Case Presentation: Herein, we report a case of 16 year-old male monozygotic twins with Angle class III malocclusion and high angle facial pattern. One of them (patient M.H) had a history of mid-face trauma at the age of 6. Radiographic and clinical examinations revealed significant nasal septum deviation and the patient demonstrated nasal airway obstruction on the right side. The effects of this traumatic injury and the consequences of septal deviation were evident both clinically and radiographically at the age of 16. Increased airway resistance caused by septal deviation significantly affected the arch form and the configuration of the nose. The overall facial growth pattern is predetermined genetically but vertical dimension of the face may be more influenced by the environmental factors.
Conclusions: Patients should be carefully monitored after trauma to the nose and face and any deviation in the facial structure should be treated promptly in order to prevent asymmetries.