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Evaluation of secondary functional cheilorhinoplasty during growth of cleft patients with residual lip and nasal deformities.
J Oral Maxillofac Surg 2008; 66(12):2577-84JO

Abstract

PURPOSE

The aim of the study was to evaluate the clinical outcomes of secondary functional cheilorhinoplasty of residual lip and nasal deformities caused by muscular deficiency in cleft patients.

PATIENTS AND METHODS

During a 4-year period, 31 patients underwent cheilorhinoplasty, including complete reopening of the cleft borders and differentiated mimic muscle reorientation. In 21 patients, remarkable residual clefts of the anterior palate were also closed. Simultaneous alveolar bone grafting was performed in 15 patients. The minimum follow-up was 1 year. Cosmetic features evaluated were spontaneous facial appearance and changes in position of the nasal floor and the philtrum. The width of the alar base was measured. For functional outcomes, deficiency during mimic movements was evaluated, using standardized photographs taken preoperatively and postoperatively. The final results, judged according to defined criteria with several clinical factors, were compared.

RESULTS

Cosmetic and functional improvement was achieved in all patients. In young patients (aged 4 to 9 years), the improvements were noteworthy. There were no differences in outcomes between the groups with and without simultaneous grafting, except for unilateral cases with minor muscular deficiency, in whom bone grafting before cheilorhinoplasty led to better results.

CONCLUSION

In cases of major muscular deficiency, early cheilorhinoplasty should be performed at age 7 years, without waiting for the usual timing of bone grafting. In minor and moderate cases, the operation can ideally be done in combination with bone grafting.

Authors+Show Affiliations

Department of Cranio-Maxillofacial Surgery, University of Bern, Bern, Switzerland.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Studies
Journal Article

Language

eng

PubMed ID

19022138

Citation

Smolka, Koord, et al. "Evaluation of Secondary Functional Cheilorhinoplasty During Growth of Cleft Patients With Residual Lip and Nasal Deformities." Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons, vol. 66, no. 12, 2008, pp. 2577-84.
Smolka K, Eggernsperger N, Iizuka T, et al. Evaluation of secondary functional cheilorhinoplasty during growth of cleft patients with residual lip and nasal deformities. J Oral Maxillofac Surg. 2008;66(12):2577-84.
Smolka, K., Eggernsperger, N., Iizuka, T., & Smolka, W. (2008). Evaluation of secondary functional cheilorhinoplasty during growth of cleft patients with residual lip and nasal deformities. Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons, 66(12), pp. 2577-84. doi:10.1016/j.joms.2008.06.044.
Smolka K, et al. Evaluation of Secondary Functional Cheilorhinoplasty During Growth of Cleft Patients With Residual Lip and Nasal Deformities. J Oral Maxillofac Surg. 2008;66(12):2577-84. PubMed PMID: 19022138.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of secondary functional cheilorhinoplasty during growth of cleft patients with residual lip and nasal deformities. AU - Smolka,Koord, AU - Eggernsperger,Nicloe, AU - Iizuka,Tateyuki, AU - Smolka,Wenko, PY - 2007/09/28/received PY - 2008/01/15/revised PY - 2008/06/16/accepted PY - 2008/11/22/pubmed PY - 2008/12/17/medline PY - 2008/11/22/entrez SP - 2577 EP - 84 JF - Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons JO - J. Oral Maxillofac. Surg. VL - 66 IS - 12 N2 - PURPOSE: The aim of the study was to evaluate the clinical outcomes of secondary functional cheilorhinoplasty of residual lip and nasal deformities caused by muscular deficiency in cleft patients. PATIENTS AND METHODS: During a 4-year period, 31 patients underwent cheilorhinoplasty, including complete reopening of the cleft borders and differentiated mimic muscle reorientation. In 21 patients, remarkable residual clefts of the anterior palate were also closed. Simultaneous alveolar bone grafting was performed in 15 patients. The minimum follow-up was 1 year. Cosmetic features evaluated were spontaneous facial appearance and changes in position of the nasal floor and the philtrum. The width of the alar base was measured. For functional outcomes, deficiency during mimic movements was evaluated, using standardized photographs taken preoperatively and postoperatively. The final results, judged according to defined criteria with several clinical factors, were compared. RESULTS: Cosmetic and functional improvement was achieved in all patients. In young patients (aged 4 to 9 years), the improvements were noteworthy. There were no differences in outcomes between the groups with and without simultaneous grafting, except for unilateral cases with minor muscular deficiency, in whom bone grafting before cheilorhinoplasty led to better results. CONCLUSION: In cases of major muscular deficiency, early cheilorhinoplasty should be performed at age 7 years, without waiting for the usual timing of bone grafting. In minor and moderate cases, the operation can ideally be done in combination with bone grafting. SN - 1531-5053 UR - https://www.unboundmedicine.com/medline/citation/19022138/Evaluation_of_secondary_functional_cheilorhinoplasty_during_growth_of_cleft_patients_with_residual_lip_and_nasal_deformities_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0278-2391(08)01040-9 DB - PRIME DP - Unbound Medicine ER -