## 2 Materials and Methods  
The research is based on a retrospective study of 55 computer tomography (CT) images of the skull performed on living people aged 27-89 years (M = 60.95), SD = 16.53), of which 24 were females (43.6%) and 31 males (56.4%). The CT images were studied from the archives of a Neurosurgery Hospital in Iasi, Romania. Only the sex and age of the patients were considered in this research--no other details as to the identity of the person were targeted. The practical procedures were carried out in accordance with the Declaration of Helsinki and the protocol was approved by the Ethical Committees of Grigore T. Popa Medicine and Pharmacy University and of the Neurosurgery Hospital (no. 9432/12 June 2020). The inclusion criteria were represented by cases where the CT scans had over 60 slices (thus allowing the creation of 3D surfaces) and the images allowed the analysis and visualization of the whole nose region. Excluded from the present study were the cases where CT images showed fracturesof the nasal bones or when the entire region of the nose could not be visualized, and it was not possible to correctly measure the nasal skull points. The study was worked out at John Moores Liverpool University, Liverpool, United Kingdom for a period of two and a half months. The resulting dataset consisted of 55 tomographic computer images that were worked on for the parameter maximum width of the nose. Images were processed using the InVesalius 3.0 software, creating separate surfaces (images) for both bone and soft tissue and exporting these images later as 3D images (obj. format). For analysis and reconstruction, the 3D images were imported into 3D Systems Free Form Modelling Plus Software using a Touch haptic feedback device. Freeform is a software with a high intelligence which can be applied in any sciences (medicine, engineering, etc.). Freeform features provide a high-level interface to a lot of representations. The purpose of freeform features is faster and more intuitive modelling with more guarantee for a high-quality design. Comparative with other ways of modelling, in freeform there is a better control over the 3D surface and it is easier to use, especially helping by touch haptic feedback device. The above-mentioned steps allowed the import of all cases separately into FreeForm, with the skulls positioned in Frankfurt Horizontal Plane (FHP). This involves drawing a plane passing through the upper edge of the external acoustic meatus and the lower edge of the orbital rim, which being viewed from the interior, posterior, and lateral (right/left), must represent a straight line. For the researched parameter, the maximum nose width (MNW) measurements were taken both on the skull and soft tissue. The measurements from the skull involved the maximum distance of the nasal aperture, for which the distance between the most lateral points of the aperture was taken into account (Figure 1). The measurements taken on the soft tissue involved the calculation of the maximum distance of the nasal alee, between the most lateral points of the nasal alee (Figure 2). Figure 1: Distance between the most lateral points of the nasal alee. Figure 2: Distance between of the most lateral points of the nasal alee. Thus, a series of measurements were made on hard tissue as well as soft tissue. For each parameter, we took two measurements and calculated an average of the two values; each measurement was made twice and rechecked. All the measurements used millimeters (mm) as measurement unit. Additionally, the intra-observer error (TEM) was calculated for a better evaluation of the two measurements which was performed by the same person. The value of TEM obtained following the methodology for TEM calculation is 0.341, which was classified as acceptable and shows that the variation between the two measurements suffers no influence of the systematic error. The resulting database was analyzed using SPSS 3.0. Several statistical tests were performed in order to analyze the data.