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Nasolabial esthetics in children with complete unilateral cleft lip and palate after 1- versus 3-stage treatment protocols.
J Oral Maxillofac Surg. 2009 Aug; 67(8):1661-6.JO

Abstract

PURPOSE

Facial esthetics play an important role in social interactions. However, children with a repaired complete unilateral cleft lip and palate usually show some disfigurement of the nasolabial area. To date, few studies have assessed the nasolabial appearance after different treatment protocols. The aim of the present study was to compare the nasolabial esthetics after 1- and 3-stage treatment protocols.

MATERIALS AND METHODS

Four components of the nasolabial appearance (nasal form, nasal deviation, mucocutaneous junction, and profile view) were assessed by 4 raters in 108 consecutively treated children who had undergone either 1-stage closure (Warsaw group, 41 boys and 19 girls, mean age 10.8 years, SD 2.0) or 3-stage (Nijmegen group, 30 boys and 18 girls, mean age 8.9 years, SD 0.7). A 5-grade esthetic index of Asher-McDade was used, in which grade 1 indicates the most esthetic and grade 5 the least esthetic outcome.

RESULTS

The nasal form was judged the least esthetic in both groups and graded 3.1 (SD 1.1) and 3.2 (SD 1.1). The nasal deviation, mucocutaneous junction, and profile view were scored from 2.1 (SD 0.8) to 2.3 (SD 1.0) in both groups. The treatment outcome after the Warsaw and Nijmegen protocols was comparable. Neither overall nor any of the 4 components of the nasolabial appearance showed intercenter differences (P > .1).

CONCLUSIONS

The nasolabial appearance after the Warsaw (1-stage) and Nijmegen (3-stage) protocols was comparable. The technique of lip repair (triangular flap in Warsaw and Millard rotation advancement in Nijmegen) gave comparable results for the esthetics of the nasolabial area.

Authors+Show Affiliations

Department of Pediatric Surgery, Institute of Mother and Child, Warsaw, Poland. pfudalej@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19615579

Citation

Fudalej, Piotr, et al. "Nasolabial Esthetics in Children With Complete Unilateral Cleft Lip and Palate After 1- Versus 3-stage Treatment Protocols." Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons, vol. 67, no. 8, 2009, pp. 1661-6.
Fudalej P, Katsaros C, Bongaarts C, et al. Nasolabial esthetics in children with complete unilateral cleft lip and palate after 1- versus 3-stage treatment protocols. J Oral Maxillofac Surg. 2009;67(8):1661-6.
Fudalej, P., Katsaros, C., Bongaarts, C., Dudkiewicz, Z., & Kuijpers-Jagtman, A. M. (2009). Nasolabial esthetics in children with complete unilateral cleft lip and palate after 1- versus 3-stage treatment protocols. Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons, 67(8), 1661-6. https://doi.org/10.1016/j.joms.2009.04.003
Fudalej P, et al. Nasolabial Esthetics in Children With Complete Unilateral Cleft Lip and Palate After 1- Versus 3-stage Treatment Protocols. J Oral Maxillofac Surg. 2009;67(8):1661-6. PubMed PMID: 19615579.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nasolabial esthetics in children with complete unilateral cleft lip and palate after 1- versus 3-stage treatment protocols. AU - Fudalej,Piotr, AU - Katsaros,Christos, AU - Bongaarts,Catharina, AU - Dudkiewicz,Zofia, AU - Kuijpers-Jagtman,Anne Marie, PY - 2008/12/03/received PY - 2009/04/04/accepted PY - 2009/7/21/entrez PY - 2009/7/21/pubmed PY - 2009/8/21/medline SP - 1661 EP - 6 JF - Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons JO - J. Oral Maxillofac. Surg. VL - 67 IS - 8 N2 - PURPOSE: Facial esthetics play an important role in social interactions. However, children with a repaired complete unilateral cleft lip and palate usually show some disfigurement of the nasolabial area. To date, few studies have assessed the nasolabial appearance after different treatment protocols. The aim of the present study was to compare the nasolabial esthetics after 1- and 3-stage treatment protocols. MATERIALS AND METHODS: Four components of the nasolabial appearance (nasal form, nasal deviation, mucocutaneous junction, and profile view) were assessed by 4 raters in 108 consecutively treated children who had undergone either 1-stage closure (Warsaw group, 41 boys and 19 girls, mean age 10.8 years, SD 2.0) or 3-stage (Nijmegen group, 30 boys and 18 girls, mean age 8.9 years, SD 0.7). A 5-grade esthetic index of Asher-McDade was used, in which grade 1 indicates the most esthetic and grade 5 the least esthetic outcome. RESULTS: The nasal form was judged the least esthetic in both groups and graded 3.1 (SD 1.1) and 3.2 (SD 1.1). The nasal deviation, mucocutaneous junction, and profile view were scored from 2.1 (SD 0.8) to 2.3 (SD 1.0) in both groups. The treatment outcome after the Warsaw and Nijmegen protocols was comparable. Neither overall nor any of the 4 components of the nasolabial appearance showed intercenter differences (P > .1). CONCLUSIONS: The nasolabial appearance after the Warsaw (1-stage) and Nijmegen (3-stage) protocols was comparable. The technique of lip repair (triangular flap in Warsaw and Millard rotation advancement in Nijmegen) gave comparable results for the esthetics of the nasolabial area. SN - 1531-5053 UR - https://www.unboundmedicine.com/medline/citation/19615579/Nasolabial_esthetics_in_children_with_complete_unilateral_cleft_lip_and_palate_after_1__versus_3_stage_treatment_protocols_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0278-2391(09)00453-4 DB - PRIME DP - Unbound Medicine ER -